AMERICAN RED CROSS 
ABRIDGED TEXT-BOOK 

FIRST AID 





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AMERICAN RED CROSS 
ABRIDGED 

FIRST AID TEXT-BOOK 

MINERS’ EDITION 


LYNCH AND SHIELDS 






AMERICAN RED CROSS ABRIDGED TEXT-BOOK 


ON 

FIRST AID 


MINERS’ EDITION 

A MANUAL OF INSTRUCTION 


BY 

MAJOR CHARLES LYNCH 

MEDICAL CORPS, UNITED STATES ARMY 

AND 

1ST LT. M. J. SHIELDS 

MEDICAL RES^IRVE CORPS, UNITED STATES ARMY 


WITH ILLUSTRATIONS 


PHILADELPHIA 

P. BLAKISTON’S SON & CO. 

1012 WALNUT STREET 
1913 


Copyright, 1913 , by P, Blakiston’s Son & Co, 




THE.MAPLE.PRESS.YORK.PA 

DEC 31 1913 


©CI,A3589S9 



PREFACE 


MINERS’ EDITION 

The needs of miners, so far as might be, in respect to first-aid 
instruction were met in an earlier book of this series which was 
called the “Industrial Edition.’’ This, however, was for other 
industries as well as for mines. Now, the spread of the first-aid 
movement in a vast number of mines throughout the country 
has seemed to demand a special book for miners. Furthermore, 
experience has shown that instruction in safety and in first aid 
should go together even more than was thought at first, though in 
all the Red Cross first-aid manuals the importance of the subject 
of prevention as a part of first-aid instruction has always been 
insisted upon. The reception of the former editions of the Red 
Cross first-aid books was very gratifying to that association and 
to the authors. It is hoped that a larger experience will make 
the present edition more useful and practical. 

The benefits to be gained from knowledge of first aid to the 
injured are becoming more apparent year by year as the subject 
is taught more widely throughout the United States. It may 
be well here to call attention to the fact that in our country this 
instruction started in the mines. Nowhere has first aid been 
learned better and nowhere has the good from knowledge of the 
subject been greater. 

As the experience of the authors has increased they have 
become more and more convinced of the ease with which first 
aid to the injured may be learned. All that is necessary is a 
serious wish to learn and a practical course of instruction. The 
first must be provided by the student and this is the reason miners 
have always been so successful in this work. It is hoped that this 
book may help in respect to the second requirement. It is not 


V 



VI 


PREFACE 


enough to read the book, however, the student must himself 
practice first aid on a comrade or on someone else supposed to 
be injured, and whenever practicable it is very important that 
this be done under the direction of a competent teacher. 

Knowledge of certain facts is necessary to all students of first 
aid to the injured. So far as these are concerned each book in 
this series is alike. On the other hand, each industry has a 
special first aid of its own. Each of the Red Cross manuals differs 
in respect to the latter. Both the authors of this small text¬ 
book have published other first-aid books and these have been 
freely used here as has seemed most advantageous. 


CONTENTS 


CHAPTER I 

Page 

What First Aid to the Injured is; General Directions 

FOR Gtvtng First Aid; Shock . i 

CHAPTER II 

Bandages . lo 

CHAPTER III 

Injuries in Which the Skin IS NOT Pierced or Broken 
Bruises; Strains; Sprains; Dislocations; Fractures. 22 

CHAPTER IV 

Injuries in Which the Skin IS Pierced or Broken: 

Wounds. 47 

CHAPTER V 

Bleeding.65 

CHAPTER VI 

Injuries Due to Heat and Cold 

Bums and Scalds; Sunstroke and Heat Exhaustion; Frost 

Bite and Freezing. 82 

CHAPTER VII 

Suffocation and Artificial Respiration: Drowning; 

Electric Shock; Gas Poisoning; Hanging .... 91 

vii 







CONTENTS 


viii 

CHAPTER VIII 

Page 

Unconsciousness or Insensibility. Poisoning .... 107 

CHAPTER IX 

How TO Carry Injured. 117 

CHAPTER X 
Miners’ Eirst Aid 

Safety. Care of Injured. 133 

CHAPTER XI 

% Organization of First Aid Instruction 

Classes; Associations; Course of Instruction; Contests and 

Red Cross First Aid Examinations and Certificates . . 175 

Index . 183 





AMERICAN RED CROSS ABRIDGED 
TEXT-BOOK ON FIRST AID 

MINERS^ EDITION 


CHAPTER I 

WHAT FIRST AID TO THE INJURED IS; GENERAL 
DIRECTIONS FOR GIVING FIRST AID; SHOCK 

What First Aid to the Injured Is 

We all know, of course, that a doctor as he has given years 
to studying the subject is best qualified to take care of ill and 
injured. On the other hand, accidents and sudden illness often 
occur where the services of physicians cannot be immediately 
obtained. The necessary delay may result very disastrously 
for the ill or injured. A very large experience has shown that 
any intelligent person can learn what to do in such emergencies. 
First aid to the injured must be learned, however, like every 
other subject and no one will know what to do for ill or injured 
unless he has studied it. But all that is necessary for good re¬ 
sults is that the student have common sense and devote the 
small amount of time required for acquiring the special knowl¬ 
edge and skill. 

Knowledge of first aid to the injured is a very valuable and very 
cheap form of insurance. Possibly we may never need this 
knowledge, but the wise man or woman would hardly be willing 
to let any building go without insurance on the chance that it 
would never burn. How much more important it is for us to 


I 



2 


WHAT PIRST AID TO THE INJURED IS 


insure our own selves against the bad results of accidents through 
knowledge of first aid to the injured. 

There is no clashing of interest between the doctor and the 
first aider. The duties of the former begin when the latter 
leave off. Knowledge of first aid enables trained persons to 
put patients into doctors’ hands in the best possible condition 
for cure. It should also enable them to recognize the severity 
of an injury or illness so that when necessary they may call a 
doctor promptly. Treatment, except of very minor cases of in¬ 
jury or illness and the care of injured and ill in an emergency 
till a doctor can be procured is not first aid. Such treatment can¬ 
not be learned from this book, and cannot be too strongly 
condemned. 

Accidents have become far too common and the attention of 
every student of first aid is earnestly invited to the great bene¬ 
fits to be gained by studying how to prevent them as part of his 
or her course in first aid. Prevention is better than cure in in¬ 
jury as well as in disease and is just as practical. In both, good 
results in this respect are mainly dependent on the action of in¬ 
dividuals. Every injury described in this book should suggest 
how the accident which caused it might have been prevented. 
Still more if any first aider cares for a real injury he or she should 
think over the cause for it carefully and so far as within their 
power take steps to prevent a similar accident in the future. 

General Directions for Giving First Aid 

If no doctor is present when an accident occurs someone must 
take charge of things. This duty naturally falls on the first 
aider. This is what he has studied first aid for and he ’should 
always stand ready to take the responsibility. In justice to 
the injured person and to himself he must not allow interference 
by other people. The only people who should be near an in¬ 
jured person are those required to help him. He needs all the 
air he can get and a crowd about him will use air that he should 
have. 

Be observant. Everything depends upon this. See every- 


DIRECTIONS FOR GIVING FIRST AID 


3 


thing and think what each thing means. Then you can hardly 
go wrong in caring for the patient. 

Be calm and don’t be hurried. -Be quiet and cool. 

If a doctor is within immediate call it may hardly be necessary for 
the first aider to do more than to send for the doctor and to 
keep the crowd away from the injured person. The action taken 
depends on the injury, however; for example, it would be very 
foolish to wait a moment for a doctor if there were danger of 
death from bleeding or in any accident where delay would be 
dangerous. On the other hand, often it may be better to have 
a doctor care for the injury from the first. In giving first aid 
it is quite as necessary to know what not to do as what to do. In 
any case if the services of a doctor can be had it is always best 
to employ them, except for slight injuries. Moreover, if any 
doubt exists in regard to this, it is best to send for a physician 
or to take the injured person to a doctor as soon as possible. 
It should be remembered that injuries which are apparently 
trivial may sometimes, if not treated promptly by a doctor, 
have serious consequences, and that a physician called in time 
may prevent conditions which when fully established are beyond 
the help of medical science. 

Tight clothing interferes with both breathing and circulation. 
The collar should be loosened at once, and also usually the belt, 
likewise anything else around the body which is tight. 

Generally speaking, if something special does not need imme¬ 
diate attention, the next thing to do is to get the injured person 
into a safe and comfortable position. The best position, unless 
there is some reason to the contrary, is on the back with the head 
low. With a flushed face, the head may be raised on a small 
pillow or folded coat; with a pale face, it should not be raised at 
all. If a person is vomiting, he should be placed on his side or 
his head should be turned to one side, so that the matter vomited 
will not go into his windpipe and choke him. Unconscious 
persons cannot swallow and so they should never be given water, 
stimulants, etc., as these will choke them by entering the wind¬ 
pipe. Slight cases of illness and injury may sit up, but one must 
be sure that all seriously injured are kept lying down. 


4 


WHAT FIRST AID TO THE INJURED IS 


Do not be hurried into moving a person from the place where 
his accident has occurred and always make sure first that he is 
not going to be injured further by being moved. It is specially 
dangerous to move persons with broken bones before proper 
treatment has been given as the ends of the broken bones are 
very sharp and cut like a knife. 

A hurt person vdll frequently ask for water, which may be 
given with perfect safety. Cold water is usually more refreshing, 
but whether cold or hot, it must be given fairly slowly so that the 
injured person has time to swallow between sips. To neglect 
giving a stimulant when it is required would be a grav^e error of 
judgment. The first thought with many people, however, is 
to procure whisky or brandy for everj* sufferer from illness or 
injury. These are reallj- as unnecessary’ for every’ case as would 
be the application of splints to the leg of every* injured man. 
They’ should never be given in injuries of the head, and it should 
be remembered that while a small quantity’ of liquor acts as a 
stimulant, large ones are depressing. If y’ou have it, always 
use aromatic spirits of ammonia as a stimulant in’preference to 
any’ alcoholic liquor. 

Whatever the injury’ may’ be, it must be seen clearly before any 
attempt is made to treat it. In order to do this it w'ill generally 
be necessary to remove some of the clothing. This is likely’ to be 
very’ painful and possibly dangerous for the injured person, 
unless he is handled with the greatest gentleness. In remov’ing 
clothing, rip up the nearest seam in the outer clothing and cut or 
tear the underclothing. The sound side should be undressed first 
so that the injured side will be subjected to less movement. In 
injuries to the foot and ankle it will rarely be possible to remove 
the boots or shoes without giving severe pain and perhaps doing 
considerable damage, so they’ should be cut freely when this is 
necessary. 

The first aider must make use of what he finds on the spot. 
He must explain clearly’ to any’ helpers just what he wants them 
to do. 

When there are several injuries the most severe should be cared 
for first. 


SHOCK 


5 


Shock 

More or less shock is caused by all injuries and it must be 
thought of, and treated when necessary. 

Description.—Shock is a more or less profound depression of 
the nervous system. It is sometimes called collapse or 
prostration. 

For the convenience of the student the human body is divided 
into various systems. One of these and perhaps the most im¬ 
portant as it regulates the action of all the others is the nervous 
system. This is a very delicate system which is easily disturbed. 
Everybody knows what a mental shock is. A person receives 
bad news, for example, he grows pale, perhaps is unable to 
move, or even becomes half conscious or totally unconscious and 
may die. We say he has received a shock. This is exactly 
what happens as the result of an injury. That is to say, shock 
always, whatever the cause, is as stated, a more or less severe 
depression of the nervous system. 

Causes.—Usually a severe injury. Some persons are sensitive 
to shock, however, and so with them more shock will follow a 
slight injury than is the case with a severe injury in less sensi¬ 
tive persons. 

Prevention.—The prevention of accidents, especially severe 
accidents. Also do not allow an injured person to see his own 
injury, as this is apt to increase shock. This is especially true 
with severe bleeding. 

Symptoms.—(This is a word whose meaning should be known 
to every first aider.’ Symptoms are everything that an injured 
or ill person shows or feels because of an injury or disease.) 
Usually appear as soon as an injury is received. Face is pale 
with an anxious expression; eyelids droop; eyes are dull and the 
pupils are large. (The pupils are the black circles in the center 
of the eye.) Skin is cold and covered with a cold sweat. The 
injured person is more or less stupid and takes no interest in any¬ 
thing happening near him. May be partly or totally uncon¬ 
scious or mind may wander. Usually he lies perfectly quiet 
and will not move unless disturbed. Breathing is feeble and 


6 


WHAT FIRST AID TO THE INJURED IS 


shallow. Pulse is rapid and weak. May not be able to feel 
it at the wrist. (The first aider should be able to count the pulse 
at the wrist. Seventy-two per minute is the usual rate in per¬ 
fect health but this varies considerably. Exercise, for example, 
increases the rate perhaps many beats per minute.) 

Usually shock is recovered from, the improvement being 
gradual but the shock may grow worse and death finally 
occur. 

It might be thought any one should easily know when a person 
is suffering from shock. This is the case usually but not invari¬ 
ably. If you see the accident and its effect you can hardly make 
a mistake but suppose you do not see the accident then you may 
have nothing to judge by except the symptoms just given. 

Treatment.—Send for doctor at once if possible. Warm and 
stimulate in every possible way before arrival of doctor. 

First, place injured person on back with head low so that plenty 
of blood will enter brain. 

Stimulants should always be given if he is able to swallow. 
Hot coffee, hot tea or half a teaspoonful of aromatic spirits of 
ammonia in a half glass of water. Whisky may be only stimu¬ 
lant procurable. If used, give one large drink only, as more is 
likely to cause depression. Ammonia or smelling salts to nose, 
help, when procurable. 

Never remove more clothing than necessary from an injured 
person as this will cause more severe shock, and when possible 
spread coats or blankets over him. 

Place hot-water bottles or hot bricks around him when possible; 
flannels wrung out in hot water applied to abdomen and chest 
have the same effect. Rubbing legs and arms toward body, 
under blankets, quickens circulation of the blood and is useful. 
Be careful while doing this not to uncover the injured person. 

Warning.—While shock is so extremely common in injuries 
that it should always be kept in mind and treated, it must not 
be forgotten that something more dangerous even than shock 
may require attention. The symptoms of severe bleeding are 
very like shock, and if shock only is treated in such a case and 
the bleeding is not stopped the patient may bleed to death. 


STIMULANTS 


7 


More about Stimulants. —Most first-aid stimulants have al¬ 
ready been mentioned but it will perhaps be well to say a few 
words more respecting their use. 

All stimulants taken internally are best given hot when possible 
as aside from the particular stimulant used, heat itself is a power¬ 
ful stimulant whether employed internally or externally. Safe 
and easily procurable stimulants are tea and coffee, a glass of 
wine, a dessertspoonful of whisky or brandy with an equal quan¬ 
tity of water, or a teaspoonful of pure alcohol with three times 
the quantity of water (not wood alcohol or denatured alcohol, 
which are poisons). 

Alcohol in some form may usually be easily procured and this 
use of alcohol is, of course, purely a medicinal one which has noth¬ 
ing to do with the question of the drinking of alcoholic liquors. 
But many people object to the use of alcohol under any cir¬ 
cumstances. In large amounts it is depressing and not stimu¬ 
lating, and for other reasons it is never advisable to carry whisky 
or brandy for first-aid purposes. Aromatic spirits of ammonia 
which has none of the disadvantages of alcohol is the best first- 
aid stimulant. It is best given in half-teaspoonful doses in 
one-half a glass of hot water. 

As unconscious persons cannot swallow, for them we must 
make use of a stimulant which may be inhaled. The best 
stimulant under these circumstances is water of ammonia, 
hartshorn, or smelling salts. This, of course, is held under the 
nose so its fumes may be breathed in. 

Heat employed externally is such a very valuable stimulant 
that every first-aid student should know how to make use of it. 
The ordinary hot-water bag is most convenient for this purpose, 
but glass bottles and jars are good. They should be covered 
with cloth or paper to prevent them from burning the patient. 
Hot bricks and stones are also useful. In using heat in this way 
it must be remembered that, especially with an unconscious 
person, there is considerable danger of causing severe burns, so 
one must make sure by testing the bottle, etc., on his arm or 
face, that it will not burn even if left in contact with the skin for 
some time. In applying heat by means of the objects mentioned, 


8 


WHAT FIRST AID TO THE INJURED IS 


to get the greatest effect, they should be placed between the 
legs, at their outer sides and between the body and the arms. A 
light hot-water bag lying over the heart acts as a special stimulant 
to it. 

Rubbing not only quickens the circulation, but is also stimu¬ 
lating. 

As has been indicated in discussing shock, all the different 
classes of stimulants are best used together when they can be 
obtained. 


QUESTIONS 

1. What is First Aid to the Injured? 

2. Suppose you have to care for an injured person. What would 
you do first. 

3. When should you send for a doctor, or take the injured person 
to a doctor? 

4. What about tight clothing? 

5. When would you move an injured person? 

6. What are the dangers of moving an injured person? 

7. What do you know about giving injured persons water; stimu¬ 
lants? 

8. Should clothing always be removed? 

9. When would you remove some of the clothing and how would 
you do this? 

10. When does shock occur? 

11. What is shock? Cause of shock? Prevention? Symptoms? 
Treatment? What is a symptom? 

12. Suppose you see a person whom you think is severely shocked, 
what would you look for in order to determine nothing more severe than 
shock had occurred? 

13. Explain the use and abuse of stimulants. 

PRACTICAL EXERCISES 

Have one of the class pretend to be injured, or secure some one else 
to act as “subject.” Members of the class should be required to show 
just what they would do for any case of injury. They should also 
be required to loosen and to remove clothing, the place of the injury 


PRACTICAL EXERCISES 


9 


having been stated. They should place the injured person in the 
proper position. The pupil of the eye should be demonstrated and 
each member of the class should be required to take the pulse. 

Show on the subject exactly what should be done in shock. 


CHAPTER II 


BANDAGES 

The first aider must learn to use his hands as well as his head. 
To know how to bandage well is necessary for him. Practice 
makes perfect in this as well as in other respects and the first- 
aid student should learn how to bandage as early as practical in 
his course of instruction and thereafter take every opportunity 
to perfect himself by constant practice. 

Kinds of Bandages 

1. The Triangular Bandage. 

2. The Roller Bandage. 

3. The Four-tailed Bandage. 

I. Triangular Bandage. —The triangular bandage is perhaps 
best suited for general first-aid work, as it can be easily made, is 
not difficult to apply as a temporary dressing and is not likely to 
be put on so tightly that it will cause injury by stopping the 
circulation of the blood. 

Some first-aid classes may desire to learn the use of this band¬ 
age alone. If so the description of the other kinds of bandages 
and their use may be omitted. For the reasons stated later, 
however, it is believed, generally speaking, skill in the applica¬ 
tion of the other bandages is desirable for the first aider. 

The triangular bandage is commonly made from unbleached 
cotton cloth, though any strong cloth will answer. Bed sheets, 
pillow cases, napkins and- handkerchiefs may all be used to 
make it. 

It is desirable that the piece of cloth for the bandage be not 
less than 34 to 38 inches square. It is folded diagonally and is 
cut across in the fold; of course this will give two triangular 

10 


ROLLER BANDAGE 


II 


bandages. While made triangular bandages may be readily 
bought, the only advantage they possess is that most of them 
have pictures showing methods of application stamped upon 
them. 

The triangular bandage may be applied in two ways: 
Unfolded. 

Folded. 

Unfolded means that the bandage is used in the form of the 
whole triangle. 

To fold, the point of the triangle is brought to the middle of 
the opposite side, and then the bandage is folded lengthwise to 
the width desired. When folded so as to make a narrow strip 
the bandage is called a cravat. 

2. Roller Bandage. —The roller bandage is invaluable for the 
surgeon but this is not the case with the first aider. The 
latter must, however, know how to make use of any appliance at 
hand, and he is very likely in an accident to find it much more 
convenient to obtain the roller bandage so it is well that he should 
know the principles of its application. 

Roller bandages are usually made of muslin, cotton cloth, 
flannel, gauze or cheese cloth, and they may be improvised by 
tearing strips from a sheet and rolling them up. By far the best 
material is gauze or cheese cloth. This is elastic and fits itself 
wtII to the part to be bandaged so that bandages made of it are 
easy to apply and do not have the disadvantages of inelastic 
bandages of muslin, which in unskilled hands are very apt 
either to be pulled so tight on one edge that they cut off the cir¬ 
culation or to be so loose that they will not stay in place. 

While roller bandages may usually be readily bought, it is well 
to know how they should be rolled. One end of the bandage 
should be turned over for a distance of about 6 inches, this lap 
should be folded on itself and this process should be repeated 
till a small hard roll is formed. Then place the bandage on the 
thigh (the foot should be on a stool or chair so that the thigh is 
nearly at right angles to the body) with roll of bandage near the 
body, length of bandage at bottom of roll and bandage extending 
down the thigh. Roll, beginning with the fingers of right hand 


12 


BANDAGES 


running down to the wrist, and repeat till bandage is completely 
rolled. The left hand is used to hold the bandage tight and even. 
The bandage when completed should be in a hard roll with even 
edges. It may be fastened with a couple of pins. 

Roller bandages are preferably used in the following sizes: 

For the finger, f of an inch wide and i yard long. 

For the arm and head, 2^ inches wide and 4 to 6 yards long. 

For the leg and thigh, 3 inches wide and 6 to 8 yards long. 

For the chest and abdomen, 4 to 5 inches wide and 8 to 12 yards 
long. 

The bandage 2| inches wide and 4 to 6 yards long is the most 
generally used. 

While it is not, of course, absolutely necessary to use the band¬ 
age best adapted in size for the part to which it is to be applied, 
it is very difficult to bandage satisfactorily a small part with a 
wide bandage. Any bandage when rolled may be easily cut 
through with a sharp knife and thus a bandage of the required 
size may always be obtained. 

The roller bandage is applied by holding the roll in the right 
hand, the loose end being in the left, and laying the outer side of 
the end on the place where it is desired to start the bandage. 

The simplest method of application is the Circular, but this 
can be used only when the part to be bandaged is of nearly the 
same circumference throughout. This is the case with the 
forearm above the wrist, and with the fingers. In first-aid work, 
however, the roller bandage is usually applied to hold splints 
or dressings in place which much extends the field of the cir¬ 
cular method of application as, especially with splints, an even 
circumference is likely to be presented. The circular method 
is also more often ayailable with gauze bandages, for on account 
of their elasticity they adapt themselves to slight pulling much 
better than do bandages made of stiffer cloth. The circular 
method of application consists simply of a series of circular turns 
from below upward, each turn overlapping the upper third of 
the one below. 

Where the part is larger at one end than the other, at the start 
a few turns should be made round and round one over the other, 


BANDAGES 


13 


THE ROLLER BANDAGE 



1. The Ciicular 


2. The Reverse 


3. The Figure-8 


THE FOUR-TAILED BANDAGE 

Be«t Use a Piece of Cloth Six or Eight Inches Wide and Three Feet Long Two to Four 
Inches should be left in Center. 



4. B 2 tndage for Forehead 


6. Bandage for Back 
of Head 


7. Bandage for Nose 


8. B^tndage for Jaw. (This 

is excellent Bandage for 
Fracture of the Jaw) 


Plate I.—Bandages. 














14 


BANDAGES 


then begin to move up the limb, using the circular method as 
long as a turn overlaps the preceding one about one-third. It 
will be found as soon as the limb increases much in size that if 
the bandage lies flat, uncoveted spaces will be left. To prevent 
these spaces the Reverse must be employed. The Reverse is 
generally considered to be the most difficult point to learn in 
the application of any bandage. 

To make the Reverse, place the thumb of the left hand on the 
lower edge of the bandage to hold it in place, slacken the bandage 
between the hands (about 3 inches) and turn the roller one-half 
over toward you. Pass the roller under the limb keeping the 
lower edge of the bandage parallel with that of the turn below, 
reverse again at the proper point and so on. The reverses should 
be made so they lie in the center of the limb or to its outer side 
and all reverses should be in one line up the limb. 

The jigure-of-?) bandage is found specially useful about joints. 
It consists of a series of loops each overlapping the one below 
by about two-thirds the width of the bandage. The middle part 
is over the bend of the joint while the loops lie one below the 
other above it. 

The spica bandage is a modification of the figure-of-8 bandage, 
having one loop much larger than the other. 

A very valuable exercise in the application of the roller bandage 
is afforded in bandaging the leg from the foot to include the hip. 
This gives an opportunity to practise all the methods of applica¬ 
tion which have been described. 

For those unskilled in bandaging, lengths may be cut from a 
roller bandage and these may be tied or pinned in place in the 
same way that the folded triangular bandage is used. Some 
special bandages made in this way from the roller are described 
in the proper place. 

3. Four-tailed Bandage. —This is especially useful for frac¬ 
tures of the lower jaw and injuries of the head. Preferably a 
piece of cloth 5 to 8 inches wide and from 2 to 3 feet long should 
be used. It should be doubled on itself and torn from each end 
until a piece about 4 inches long is left undivided in the middle. 


HOW TO FASTEN BANDAGES * 15 

The 4-inch roller can be used to make this bandage for the lower 
jaw; it is rather too narrow for the head. The four-tailed band¬ 
age is made from it exactly as described above. 

How to Fasten Bandages 

Triangular and four-tailed bandages are usually completed 
by tying the ends together securely though they may be pinned, 
and frequently with triangular bandages flaps are held in place 
by pinning. The free end of'the roller bandage is usually turned 
over and pinned in place. Other pins are frequently used to 
hold the different layers of the roller bandage from slipping. 
A convenient method sometimes employed in securing a roller 
bandage is to rip the bandage down the center, then to tie a knot 
to prevent further ripping and carrying the ends around the limb 
in opposite directions, tie. 

Knots should be placed where they do not cause discomfort 
and where they may be easily reached. If you know the reef 
knot use it, if not, three knots are quite as secure. Safety pins 
are better than ordinary pins as they hold better and scratching 
is prevented. 


Precautions 

Whatever the bandage used, care must be taken that it is not 
put on too tightly. It must not be so tight that it constricts 
at any point, for this will cut off the blood supply, and if the 
bandage is left in place for some time even so severe an injury as 
mortification or actual death of the part below may be caused. 
Pain, swelling and blueness or coldness of limb below the band¬ 
age show that the bandage is too tight and should be loosened 
or removed. 

Always bandage firmly, but never too tightly or loosely. 

Always in bandaging a limb, leave the tips of the fingers or of 
the toes uncovered so that they may be seen. 

Always place the part to be bandaged in the position in which 
it is intended to leave it, as otherwise change of position may 
result in cutting off the circulation by drawing the bandage too 
tight at some point. 


i6 


BANDAGES 


Never put on a bandage under, but always over a splitit. 

Always in applying a bandage immediately after an injury, 
remember that there may be swelling and use care in order that 
the bandage may not become too tight from this cause; always 
be ready to remove or to loosen a bandage when such swelling 
makes it too tight. 

Never apply a bandage wet, for as it dries it will shrink and 
become too tight. 

Always bandage from below upward with the roller bandage. 

Never reverse the roller bandage over a sharp bone and always 
use the figure-of-eight over a joint. 

Uses of Bandages 

Bandages are used: 

1. To keep dressings in place. 

2. To hold splints in place. 

3. To stop bleeding by pressure. 

4. As slings. 


Application of Bandages 

Head Bandages.— Fold a hem about ih inches wide at the long 
side of the unfolded triangular bandage. Place the bandage 
so that the hem lies squarely across the forehead just above the 
eyes and the bandage is over the head with the point hanging 
down the back. Carry the two ends around the head above the 
ears, cross at the back and tie them across the forehead. Draw 
the point down tight, turn it up and pin it at the top of the head 
with a safety pin. (Plate II.) 

This is a useful bandage. 

The four-tailed bandage is also useful as a head bandage. It 
is applied in three ways. For the front of the head the center 
of the bandage is placed on the forehead and the ends crossed 
are tied at the back of the head and under the chin; for the top 
of the head the center of the bandage is placed there and the 
ends crossed are tied low at the back and under the chin; for the 
back, center is put at back of the head and the ends crossed, are 
tied at forehead and under chin. (Plate I.) 


BANDAGES 


17 


TRIANGULAR BANDAGE 
This Bandage may be folded into a scarf and used on any part of the body 



7. Arm Sling 


8. Arm Sling from Shirt Sleeve 


Plate II.—Bandages. 


2 

















i8 


BANDAGES 


Eye Bandage. —Place the center of the cravat made from the 
triangular bandage over the injured eye, bring the ends to the 
back of the head and tie. (Plate II.) A length cut from the 
roller bandage may be used in the same way. 

Nose Bandage. —Four-tailed. Place center on nose, cross 
ends, carry one pair below and other above ear and tie both at 
back of head. 

Jaw Bandage. —For this, two cravats are necessary if made 
from triangular bandage. Apply the center of the first across 
the chin in front, bring the ends to the back of the neck and tie. 
Place the center of the second cravat under the chin, cross the 
ends over the top of the head, bring them down and tie under 
the chin. 

An excellent bandage for the jaw may also be made from the 
four-tailed bandage. The center is placed with its middle at the 
point of the chin and the ends are crossed, one pair being tied 
at the top of the head and the other at the back of the neck. 

A single wide cravat may be placed under the chin, with the 
ends carried to the top of the head and tied there or a length 
from a roller may be used in the same way. 

Neck Bandage. —The center of the cravat of the triangular 
bandage or of a length from a roller bandage is placed over the 
injured place and the ends are carried around the neck and tied 
as convenient. This bandage may sometimes be improved by 
the use of a cardboard support which is held firmly in place be¬ 
tween the layers of the bandage. 

Chest and Shoulder Bandage. —The triangular unfolded is 
used. The long side is placed horizontally across the chest, the 
upper end is brought over the shoulder, and the ends are tied 
at the back. 

Chest and Pelvis Bandage. —A wide roller is applied around 
and around the body. Triangles in the form of cravats may 
also be used. (Plate VIII.) 

Hand Bandage. —The triangular bandage is spread out. The 
hand is placed on it, palm down, with the fingers toward the 
point (if desired, the hand may be closed), and the wrist is at 
the long side. The point is then brought over the back of the 


BANDAGES 


19 



Plate III.—Bandages. 
























20 


BANDAGES 


hand to the back of the wrist and the two ends are crossed over 
the wrist and tied. 

Bandage for Palm of Hand. —Place the center of the cravat 
on the palm of the hand, cross the ends at the back cf the hand 
and again at the front of the wrist and tie at the back of the 
wrist. (Plate II.) 

Crotch Bandage. —This is the T bandage. It is made from 
two lengths of a 3-inch roller bandage. To the center of one of 
these, 11 yards long, is sewed or pinned at right angles the 
other, which is i yard long. The bandage is applied by placing 
the long strip around the waist with the short one at the middle 
of the back. The long strip is then pinned in front and the short 
strip is brought forward between the legs to join the long one at 
the center in front where it is pinned. 

Foot Bandage. —Spread out triangular bandage. Place foot 
in center with toes toward point. Raise point over toes to 
instep in front. Bring both ends forward, cross them over 
instep and tie them round the ankle. 

Bandages for Splints and Dressings. —When roller bandages 
are used to hold splints or dressings in place they are wound 
around and around in the manner already described. For the 
same purpose cravats are made of triangular bandages. 
These are simply carried around the splint or dressing and the 
limb, body or head and are tied in place. The number of cravats 
is dependent on the length of the splint or dressing. 

Slings.— I. Arm slings: 

Place one end of a triangular bandage over shoulder of unin¬ 
jured side. Allow length of bandage to hang down in front 
of chest so that point of triangle will be behind elbow of injured 
arm. Bend elbow of injured arm to a right angle. This will 
bring forearm across middle of bandage. Then carry lower end 
of the bandage over the shoulder of the injured side and tie to 
the upper end behind the neck. Bring the point of the bandage 
at the elbow forward to the front and pin there so that bandage 
is snug but does not pull. 

This makes an excellent arm sling, but even without a bandage 
a good sling may be made for the arm by pinning the sleeve or 


PRACTICAL EXERCISES 


21 


the skirt of the coat to the front of the coat. The shirt may be 
used in the same way. 

The cravat may also be used for an arm sling. For this pur¬ 
pose it is employed in the form of a loop which encircles the fore¬ 
arm bent at a right angle and the neck. 

Still another arm sling is made from the roller bandage. For 
this a 3- or 4-inch roller is required, preferably the latter. 
Bend the forearm on the arm at the angle at which it is desired 
to hold it; this is usually about a right angle. Put the end of the 
roller about midway between the forearm and shoulder and hold 
for a moment to get length required when it may be allowed to 
drop. But before doing so pass roller in front and under forearm 
just in front of the elbow. Then carry roller along front of chest 
to the shoulder on the injured side, over this shoulder to back 
of neck, in front of sound shoulder, down to make loop for hand, 
back over sound shoulder, back of neck and in front of shoulder 
of injured side to starting point where length required will be 
cut off and the ends will be tied together. Two loops have, of 
course, been made, one for the forearm near the elbow and the 
other for the hand. 


QUESTIONS 

1. What are the different kinds of bandages? 

2. What are the advantages of the triangular bandage for first-aid 
purposes? 

3. What is the size of the triangular bandage? 

4. What is the best material for the roller bandage? 

5. Sizes of the roller bandage for different parts of the body. 

6. What are the spica and the figure-of-eight bandages used for? 

7. How would you make a four-tailed bandage? 

8. What precautions must be taken in putting on bandages? 

9. For what purposes are bandages used? 

PRACTICAL EXERCISES 

Show the different bandages and how the triangular bandage is 
used, unfolded, folded and as a cravat. 

Put bandages on the different parts of the body and show how they 
are used to keep splints and dressings in place and as slings. 

As much practice in bandaging by the class as time permits. 


CHAPTER III 


INJURIES IN WHICH THE SKIN IS NOT PIERCED OR 
BROKEN 

Bruises, Strains, Sprains, Dislocations and Fractures 

These are the commonest injuries and no one can hope not to 
suffer from some of them. Of course many bruises and strains 
are unimportant. 

Causes. —These injuries are all caused by violence in the form 
of blows or falls, or by wrenching the body. 

This does not apply to all compound fractures,* however, as 
will be seen later. 

Prevention. —These injuries occur under so many different 
circumstances that it is impossible to suggest other than the most 
general means for preventing them. It is safe to say, however, 
that a great many of them result from carelessness and that 
especially in dangerous places, people should be more alive to 
their surroundings. In other words, they should always exercise 
common care. 

Posted directions should always be observed. Such directions 
are not arbitrary, as they are, unfortunately, sometimes regarded, 
but represent the teachings of experience. 

Structure and Mechanics of the Body. —Before studying these 
injuries it will be necessary to know something of how the body 
is made. The body has both hard and soft parts. The bones 
are the hard parts and the muscles and the internal organs, such 
as the heart, lungs, liver, etc., constitute the soft parts. 

* Compound fractures are more conveniently described under frac¬ 
tures, though properly they are wounds and first and foremost require 
the treatment of such injuries. 


22 


BONES 


23 


BONES 

The bones are hard and firm and together make up the Skeleton. 
The skeleton— 

Forms a strong and rigid frame-work for the body. 

Supports and carries the soft parts. 

Protects vital organs from injury. 

Gives attachment to muscles. 

Forms joints so that movements are possible. 

The skeleton is divided into three parts: 

1. The Head, made up of the Cranium, a bony case which en¬ 
closes and protects the brain; and the Face, with the eyes, ears, 
nose and mouth. The only movable bone in the head is the 
lower jaw. 

2. The Trunk, which is divided into two parts by a muscular 
partition—the diaphram. The upper portion is the Chest, which 
contains the esophagus or gullet, the lungs, the heart and some 
large blood-vessels. The lower portion is the Abdomen, in which 
are found the stomach, liver, kidneys, bladder, the intestines and 
other organs. 

The trunk is formed of several bones which are of interest to the 
first-aid student. 

The Spinal Column, a strong pillar with several curves, is made 
up of a number of bones called vertebrae with a softer substance 
called - cartilage between them. At its lower end, the spinal 
column terminates in the broad Sacrum or Rump Bone and the 
pointed Coccyx. The spinal column supports the head and the 
ribs, and is itself supported on the pelvis. 

The Ribs, 12 in number, form the greater part of the walls of 
the chest. All the ribs are connected to the spinal column be¬ 
hind, but the two lower ones on each side are shorter than the 
others and are not connected to anything in front. The 10 upper 
ones on each side are united to the Breast-bone. 

The Breast-hone or Sternum is a flat, dagger-shaped bone which 
forms the front on the chest. Above it forms joints with the 
Collar-bones, or Clavicles, being notched for the purpose on each 
side. 


2 4 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 


















JOINTS 


25 


The Pelvis is a wide, strong, bony basin formed of the Haunch 
bones at the front and sides and partly behind where it is closed 
by the sacrum and coccyx. It supports the trunk and forms 
joints with the lower limbs. 

3. The Upper and the Lower Limbs. —Each upper limb is 
made up of the Scapula or Shoulder-blade, a flat, triangular bone 
at the back of the shoulder; the Clavicle or Collar-bone, a curved 
long bone placed horizontally across the upper part of the chest 
above the first rib; the Humerus, the bone of the upper arm; the 
Radius and the Ulna, the two bones of the forearm; and the 
Hand, which has 8 small, irregular bones in the Carpus or wrist, 
five Metacarpal Bones for the hand itself, and 14 bones. Pha¬ 
langes, in the fingers and thumb. 

Each lower limb is made up of the Femur or Thigh-bone; the 
Patella or Knee-cap; the Tibia and Fibula, the two leg bones; 
and the Foot. The foot is made up of the Tarsus, with seven 
irregular bones, which form the heel, part of the ankle, and the 
instep, 5 Metatarsal Bones for the middle of the foot; and the 
toes with 14 bones. Phalanges. 

The principal interest which bones have for the student of first 
aid is that they may be broken or fractured, one of the commonest 
accidents. 


JOINTS 

Wherever two or more bones are in contact or touch each other 
they form a joint. The ends of bones forming a joint are covered 
with a smooth substance called cartilage or gristle, so that they 
may move without friction on each other. Joints are hermeti¬ 
cally closed by a flexible sac, the capsule, which secretes an oily 
fluid. This fluid lubricates a joint just as oil does an engine. 
The ligaments of a joint are strong, fibrous bands which hold the 
bones together. The most important joints to study are the hip 
and shoulder, which are ball-and-socket joints having movements 
in all directions, and the elbow, wrist, knee and ankle, hinge 
joints. These have only to and fro movement like an ordinary 
hinge. 


26 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

Joints are of importance to the student, as bones are liable to 
be put out of place or dislocated at the joints. 

MUSCLES 

The movements of bones at the joints are caused by the Muscles. 

The muscles, the flesh or meat, form two-fifths of the body by 
weight. They are made up of red fibers which have the power 
of shortening or contracting, so that if one end of a muscle is fixed 
and the muscle is contracted the other end will pull on and move 
whatever it is attached to. By doing this muscles cause all the 
movements of the body. For example, the biceps, the big muscle 
at the front of the upper arm, in contracting causes the elbow- 
joint to bend by bringing the forearm closer to the upper arm. 
All muscles are somewhat on the stretch, as otherwise prompt 
movement would be impossible. Some of the muscles are 
attached to bones by Tendons or Sinews. These are strong, 
fibrous cords. They may be well seen in the wrist. 

Muscles are of great interest both in fractures and in disloca¬ 
tions, as their pulling causes displacements and their resistance 
offers the chief obstacle to setting fractures and to reducing 
dislocations. 


SUBCUTANEOUS TISSUE 

This name is given to the fatty layer or padding which lies 
immediately beneath the skin. In this are found many small 
blood-vessels and nerve endings. The force of a blow or fall is 
often expended on this tissue. 

The injuries which will now be spoken of affect the structures 
of the body which have just been described. 

BRUISES 

Description.—These are the commonest injuries. When a 
person falls and strikes some part of his body or when he is 
struck by something, usually the skin in not broken, but the 


MUSCLES 


2 


ff 

/ 



IIPiTO 


OMB/CUlAtHS FALfCBffABUM. 


OftBfCt/LABtS OfttS 


MASSET£R 


V/l 

// 

' .V' 








Plate V.—The muscles. {Brubaker.) 
















28 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

force of the blow or fall injures the subcutaneous tissue, which lies 
immediately beneath the skin, breaking numbers of small blood¬ 
vessels therein. Blood escapes from these small vessels and this 
causes the swelling and the ordinary black-and-blue spot which 
is due to the blood which has escaped. 

Causes. —Blows or falls. 

Symptoms. —Pain at once from injury to nerves. Sw^elling 
from escape of blood from blood-vessels. Black-and-blue spot 
from same cause. Pain also later from pressure of this blood 
on sensitive nerves. 

Pain is increased by movement. 

Treatment. —Slight, no treatment. More severe, object is 
to limit swelling and to decrease pain. At once: Ice or very, 
hot or very cold water, or half alcohol and half water. Arnica 
or witch-hazel. These contract the injured blood-vessels and 
so prevent escape of more blood and also deaden the nerves to 
some extent, thus relieving pain. Ice may be applied directly 
to injured part. Best in using liquid remedy to wet cloth with 
liquid and then to apply cloth. Raising bruised part diminishes 
pain, as it diminished the blood-supply. In arm, when severe 
and movement is painful, use a sling. No doctor is usually 
required for a bruise. 

Warning. —A bruise may be only the least important part of 
an injury. So with a bruise always try to make sure there is 
no other injury, such as a broken bone. 

Bruises of the chest and abdomen sometimes result in internal 
injuries. These may be very dangerous from breaking of the 
blood-vessels of the lungs, of the abdominal organs, or from 
actual rupture of the soft internal structures. Severe bruises of 
this character therefore demand the immediate attention of a 
physician. In case shock is very severe after a bruise of the 
abdomen or chest, serious injury of the internal organs should be 
suspected. 

STRAINS 

Description. —A strain is the name given to the injury produced 
by overstretching of a muscle. In severe strains small blood- 


SPRAINS 


29 


vessels in the muscles are often broken so that blood escapes 
into the muscles in the same way that, with a bruise, blood 
escapes into the subcutaneous tissue. The commonest strains 
are of the muscles of the back and shoulders and of the small 
tendons of the wrist and ankle. 

Cause.—Usually a sudden wrench—may be due to lifting 
too heavy a weight. 

S5rmptoms.—Pain, increased on movement. Stiffness. 

Lameness. More or less swelling. 

Treatment.—Not necessary to call doctor unless severe. 
Absolute rest at first. Alcohol and water, arnica or witch hazel 
gently rubbed in to deaden pain. In both upper and lower 
limbs, rubbing should always be toward the body. Later such 
rubbing may be harder to help absorption and to make strained 
muscles more supple. When pain and stiffness are less, gentle 
movement should be practised until both have entirely 
disappeared. 


SPRAINS 

Description.—Sprains are injuries of joints. They result 
from violent stretching, twisting and partial breaking of the 
ligaments about a joint and are sometimes accompanied by actual 
breaking of the bones. The twisting or stretching results in 
breaking of the blood-vessels and the escape of blood and of 
blood-serum (the liquid part of the blood) both around and 
into the joint. Sprains of the wrist and ankle are most common. 

Cause.—Unnatural movement of a joint. Sometimes the 
cause is a slight one, such as twisting the foot in stepping down 
from a street curb. 

S5miptoms.—Severe pain immediately. Pain is much in¬ 
creased by movement of the joint. Swelling of joint. Bones 
are not out of place and appearance of joint is unchanged except 
for the swelling. Shock when severe. 

Treatment.—Call doctor always when severe or when in doubt. 
Always begin treatment at once whether doctor has been called 
or not. Absolute rest in order not to do more damage by 


30 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

rubbing of the injured joint surfaces together. This means that 
the patient should not be allowed to move the joint or to step on 
it. Elevate joint when possible and apply heat or cold. Less 
blood will come to the injured joint if it is elevated and heat or 
cold contracts the blood-vessels and thus limits the escape of 
blood and serum. Cold may be applied in the form of snow or 
crushed ice in a cloth. It is usually better to use cloths wrung 
out in very hot or very cold water or to shower the joint with 
very hot or cold water. Putting sprained joint under a cold or 
hoL water tap is also excellent. 

Either heat or cold should be made use of sufficiently long to 
get full benefit from it, that is to sa>, from 24 to 48 hours. At 
first on the application of either heat or cold, the pain may- 
increase, but after an hour, at the latest, it will commence to 
improve and will finally disappear. Remember there may be 
shock and, if so, treat. 

Warning.—A severe sprain, especially a sprain of the ankle, 
is by no means a trivial injury but one which demands the ser¬ 
vices of a physician. 


DISLOCATIONS 

Description.—Dislocations are injuries of joints and are due 
to the head of a bone slipping out of its socket. A dislocation 
cannot occur, except in a joint which has been dislocated before, 
without tearing the ligaments which keep the bones of the joint 
close together. Some persons, however, on account of frequent 
dislocations of the same joint have its ligaments so stretched 
that not only is dislocation easy, but no further injury of the 
ligaments results from it. By far the most frequent dislocation 
is that of the shoulder-joint, which occurs in one-half of all cases 
of dislocation. But dislocations of the hip-joint, the jaw and the 
fingers are not particularly uncommon. 

Causes.—Dislocations are usually caused by a blow or a fall, 
but sometimes result from a violent muscular effort, such as 
throwing a stone. 

Symptoms.—Deformity; that is, the joint has an unusual 


DISLOCATION OF LOWER JAW 


31 


appearance, because the head of the bone is not in its proper 
place. This may be best seen by comparing the injured with the 
uninjured side of the body. 

The limb in which a joint is dislocated may be either longer or 
shorter than the uninjured limb. This depends on the direction 
in which the dislocation has taken place. The head of a dis¬ 
located bone may often be felt out of its place. Limited move¬ 
ment as the displaced head of the bone is tightly held in its new 
position. Pain from pressure by the displaced head of the bone 
on sensitive nerves. Swelling from bruising of the soft parts 
by the displaced head of the bone but is often not noticeable. 
Shock. 

Treatment. —Send for a doctor at once. Treat shock if neces¬ 
sary. Always await the doctor’s arrival except in dislocation 
of the jaw, the fingers, and the shoulder, without attempting to 
put the head of the bone back in its proper place. This is called 
reducing a dislocation. 

Remember that attempts to reduce dislocations, other than 
those of the finger and jaw, by one without a doctor’s training 
may result in great harm to the patient, for the movements 
necessary to do so may cause serious injury to the blood-vessels, 
nerves and soft parts. 

When no attempt is made to reduce the dislocation, the patient 
should be put in a comfortable position and the injured joint 
should be covered with cloths wrung out in very hot or very 
cold water so as to contract the vessels and to prevent swelling 
as much as possible. 

Dislocation of the Lower Jaw 

This may usually be successfully treated by almost anyone. 
This is fortunate, as a dislocated jaw with the open mouth in 
consequence is most painful and uncomfortable. To reduce 
a dislocation of the jaw, both thumbs must first be wrapped in 
several layers of cloth so that they will not be liable to injury. 
Both thumbs are then placed in the patient’s mouth resting on 
his lower teeth on each side while the fingers seize the lower 


32 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

jaw outside. First pressure is made downward and then back¬ 
ward. As soon as the jaw starts into place the thumbs should be 
slid off the teeth to the inside of the cheeks or they will be caught 
between the teeth when the jaw springs into place. The over¬ 
stretched muscles act just like rubber bands and one must be 
quick or his thumbs will be injured. When dislocation is re¬ 
duced put on jaw bandage. 

Dislocation of the Fingers 

These, not including those of the second joint of the thumb, 
present no great difficulties to the first aider. The dislocated 
finger should first be grasped firmly on the hand side. The end 
of the finger should then be pulled straight out away from the 
hand and the bone will usually slip into place. No bandage 
will be required. 


Dislocation of the Shoulder 

No attempt should be made to reduce this dislocation if the 
services of a physician can be obtained within a reasonable 
time, say four hours. Make your decision on this point at once, 
for if you are compelled to attempt to reduce the dislocation 
you must get to work immediately before the muscles have be¬ 
come set and rigid from the irritation caused by the displaced 
head of the bone. 

Frequently little difficulty will be experienced in reducing a 
dislocation of the shoulder, especially if the joint has been dis¬ 
located before. To accomplish it, the patient should be made 
to lie down flat on his back. The person who is going to try 
to reduce the dislocation should then sit down beside him on 
the injured side facing toward his head and should place the 
heel of his foot nearest the injured person, after the shoe has been 
removed, in the arm-pit of the patient’s injured side and then 
draw down the dislocated arm and drag it toward the uninjured 
side at the same time pressing outward and upward with the heel. 
This will usually force the upper end of the dislocated bone out- 


DISLOCATION AND FRACTURE 


33 



Plate VI.—Dislocation and fracture. 


3 













34 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 


ward, and as soon as it is free it will snap back into place. In 
order to keep the bone in place, the arm should then be band¬ 
aged to the side with the forearm carried across the chest and 
the hand placed on the opposite shoulder. 

Warning. —In case difficulty is experienced in reducing any 
dislocation, stop at once. 


FRACTURES 

Description. —When a bone is broken, the injury is called a 
fracture. Our bones are brittle and when the force used against 
them is sufficient they break much as would a dry stick. Frac¬ 
tures are among the commonest severe injuries, ten times as 
common as dislocations. About two-thirds of all fractures are 
of the bones of the limbs. Next in frequency are those of the 
collar-bone and ribs. Fractures of the skull, spine and pelvis 
are comparatively rare. 

A simple fracture is one in which the skin is not pierced. 

A compound fracture is one in which the skin is pierced. 

Causes. —Simple; blows and falls. Compound: also—from 
bad handling of simple fractures and from wounds. 

Prevention. —Simple: as given under general heading. Com¬ 
pound: also—by proper handling of simple fractures and the 
prevention of wounds. 

Symptoms. Simple fracture. —The injured person has had 
a blow or fall. Pain at point of fracture. Tenderness at point 
of fracture. Person injured is unable to move broken limb. 
Deformity; a fractured limb will be altered in shape and 
shortened or bent. Always compare with the uninjured side. 

Recognition by touch—an inequality may often be felt by 
running finger along a broken bone. 

Loss of rigidity of bone. On moving a limb in which a bone is 
fractured, instead of the bone being moved as a whole it will be 
noticed that at the point of fracture there is unusual movement, 
something like that of a hinge. 

Crepitus. This is the surgical term applied to the grating 
which is heard or felt when the broken ends of the bone rub on 
each other. 


SIMPLE FRACTURE 


35 


Shock. 

Warning. —As one may do great harm by moving a broken 
bone, for the broken ends are likely to be very sharp, it is much 
safer when an injured person is unable to move a limb, and from 
appearances it seems probable that a fracture has occurred, to 
conclude that it is a fracture without further examination, and 
to so treat it. 

Treatment. Simple Fracture. —Send for a doctor. Treat 
shock. 

The object of the further treatment before the doctor’s arrival 
is to prevent more injury, especially puncture of the skin by the 
sharp, knife-like edges of the broken bone. If this occurs the 
simple fracture is, of course, converted into a compound fracture. 
In the former injury there is no chance of wound infection as the 
unbroken skin prevents germs from reaching the break in the 
bone, while in the latter the skin is cut through and in conse¬ 
quence germs reach the broken bone ends and infection occurs. 
So instead of the few weeks of comparatively painless healing 
of the simple fracture without much danger, a compound frac¬ 
ture is caused with probable wound infection, inflammation, 
pus or matter, and perhaps months of sickness from blood- 
poisofiing, with considerable danger of death. In the treatment 
of simple fractures your principal object is accomplished by 
preventing movement of the ends of the broken bone. 

If the doctor may be expected to arrive promptly, nothing 
need be done except to put the patient in a comfortable position. 
If it is evident that in order to do this the broken bone will be 
moved, it must be supported firmly by your hands. One hand 
should support the broken bone on each side of the break. The 
bone must not bend. 

Afterward the broken bone had best be supported in the natural 
position on a pillow or a folded coat. In so supporting it great 
care must be taken that it is not bent or does not drag on the 
point of fracture. 

If the patient must be moved more that slightly, as just 
described, the broken bone must be set; that is to say, it must 
be gently drawn into its natural position, always determining 


36 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

this by comparing it with the opposite side, and held there firmly 
by splints. 

If the injured person is wearing thin summer clothing, it will 
not usually be necessary to remove the clothing in order to exam¬ 
ine for fracture. In fact, it will be better not to try to do so, 
as this may result in injury from moving the sharp ends of the 
bone, and when the clothing is left on it furnishes excellent 
padding for splints. With thick clothing, however, very likely 
one will not be able to tell that a fracture has occurred or what the 
character of the injury is. In this case never try to take off the 
clothing, but cut it in the seams with a sharp knife or scissors. 

Symptoms. Compound Fracture.—Besides the symptoms 
already described, there is a wound leading down to the broken 
bone, or the broken end of the bone sticks through the skin. 

Treatment. Compoimd Fracture.—i. Send for doctor. 

2. Treat shock. 

3. Expose fracture by cutting clothing. 

4. Turn back clothing from wound. 

5. Always treat wound first, then fracture. 

6. Do not touch wound with fingers or anything else. 

7. As soon as possible procure an antiseptic or surgically clean 
compress and place it on the wound. 

8. Then use same precautions as in simple fracture to prevent 
movement of sharp ends of broken bone. (Splints and padding.) 

9. If a sharp bone is button-holed through the skin, as fre¬ 
quently happens, do not attempt to restore it to its place, but 
after dressing wound, hold it in position as it is with splints. 

Warning.—Never in any fracture attempt to transport the 
injured person until the broken bone is firmly held in position 
by splints. 

More about Splints.—Splints are used for fractures and sus¬ 
pected fractures. Their purpose is to prevent movement at the 
point where a bone is broken. They must, therefore, be made of 
a stiff material. For first-aid purposes splints must generally 
be improvised from something which may easily be procured 
on the spot. Such articles are pieces of wood, broom handles, 


FRACTURES 


37 



Plate VII.—Fractures. 






















































38 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

lathes, rules, squares, wire netting, heavy cardboard, umbrellas, 
canes, pick handles, spades, rolls made of blankets or cloth, 
pillows alone or with pieces of board outside, rifles, swords and 
bayonets. With a broken leg it is possible to use the other leg 
as a splint 

In improvising splints a few precautions should be observed. 
Besides being rigid enough to prevent movement at the point 
where a bone is broken, they should be long enough to prevent 
movement at the nearest joints, as this will move the broken 
bone, and they should preferably be as wide as the limb to which 
they are applied, as otherwise the bandages holding them on 
will press on the limb as well as on the splint and thus cause 
pain and perhaps displace the ends of the broken bone. On 
account of the danger from swelling and in order to promote the 
comfort of the patient and not to rub the skin, splints should be 
well padded on the inner side with some soft material. The 
clothing sometimes answers this purpose fairly well when it is 
not removed. Substances generally used are cotton batting, 
waste, tow, flannel, pieces of cloth, grass, etc. If splints are not 
well padded, the limb to which they are applied must be watched 
with special care because the swelling is likely to make the splints 
too tight which will cut off the circulation and may cause morti¬ 
fication. 

Special Fractures 

Fracture of Upper Arm and Forearm 

Symptoms. —These fractures may almost always be easily 
detected by the symptoms already given. 

Treatment. —Send for doctor. Treat shock. Gently 
straighten limb so as to put it in natural position. Secure two 
splints long enough, in upper arm to extend from shoulder 
and arm-pit to elbow, and in forearm from elbow to middle of 
hand. These are best flat boards; shingles are excellent, but 
may be of any stiff material, such as twigs, covers of wine bottles, 
tin troughs, etc. Pad splints well. In upper arm, apply one 
splint to inner and the other to outer side of arm. Support by 


CRUSHED HAND OR ROOT 


39 


sling. In forearm: Place forearm across the chest, thumb up. 
Apply one padded splint—clothing will do for padding—to 
outer side from elbow to beyond wrist and the other to inner 
surface extending to tips of fingers. Support by sling. 

Broken Wrist 

This is an extremely common injury resulting from a fall on 
the hands which are put out in falling forward to prevent the 
body from striking the ground. 

Symptoms. —This belongs to a class of fractures to which the 
name impacted is given. The force of the injury actually drives 
one bone into the other so that they are held together. Great 
deformity, no crepitus, movement, etc. 

Treatment. —Send for doctor. Treat shock. Do not attempt 
to free bones, but leave them as they are. Otherwise treat like 
fracture of forearm. 


Broken Fingers 

Symptoms. —Usual symptoms of fracture, which is easily 
detected. 

Treatment. —Gently draw into natural position. Put narrow 
padded splint under finger and hold it in place with a narrow 
bandage. Support hand in sling. Show to doctor as early as 
practicable. 


Crushed Hand or Foot 

Symptoms. —Are due to a heavy weight falling on or passing 
over the hand or foot. Many or few of the bones of the wrist 
and hand or the foot and ankle may be crushed. Usual symptoms 
of fracture. Much pain. Great swelling. 

Treatment. —Hand: Apply a padded splint to the front of. 
the hand. This should be as wide as the hand and long enough 
to go from the middle of the forearm to beyond the tips of the 
fingers. 

Foot: Remove shoe. Padded splints, bottom of foot from 


40 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

heel to toes. A figure-of-8 bandage will be found most conveni¬ 
ent to hold this in place. Raising foot will relieve pain. 

Fracture of Lower Leg 

Symptoms.—As given above. Patient falls to ground. Is 
not usually difficult to detect fracture. 

Treatment.—Send for doctor. Treat shock. Secure pillow, 
sack stuffed like pillow with hay, straw or the like or a blanket 
rolled so as to make trough. Gently lift the leg to pillow, or on 
to the trough of the blanket, placing one hand above and the 
other below break, under leg, always holding in natural position. 
Then should not allow toes to turn in or out, but should be sup¬ 
ported in same position as toes of uninjured leg. Nothing further 
unless must move patient. If this must be done the leg should 
be drawn into natural position and splinted. Use two splints 
when procurable. Though any stiff material may be used for 
these splints, preferably they should be of thin boards longer 
than the leg so as to prevent movement at the knee-joint, and 
wider than the leg is thick. The splints may be applied outside 
of pillow, one at the inner and the other at outer side of leg. 
They should be held in place by 3 or 4 strips of cloth, straps or 
handkerchiefs passed around splints, pillow and leg and tied. 
Care must be taken that none of these strips is directly over 
break, as this will cause intense pain by pressure. The pillow 
alone makes a fairly good support even without splints. Splints 
also may be used without a pillow. If this is done the clothing, 
straw, hay, cotton, leaves or something else soft must be used for 
padding under the splints, which are tied in place in the way- 
described above. In case of emergency anything stiff of suffi¬ 
cient length, such as a cane, umbrella or the like, may be used 
for the outer splint, the other leg being used for the inner splint. 
The strips of cloth or handkerchiefs are then passed around the 
splint and both legs and tied as before. 

Fractures of Thigh 

Symptoms.—As above, patient falls to ground. May be 
diffiicult to detect fracture on account of thick muscles. 


FRACTURE OF COLLAR-BONE 


41 


Treatment.—The necessity of procuring a physician and of 
treating shock are greater than in fracture of the leg. Remarks 
in reference to careful handling of broken bone in fracture of the 
lower leg, apply. If difficult to detect fracture, treat as fracture. 

A long splint extending in a solid piece from foot to arm-pit 
is required for outside splint to prevent movement of hip-joint. 
This should be firmly fixed by encircling strips of cloth to the 
chest as well as to the limb. Seven strips will be required. 
Inner splint had best extend from crotch to foot. If no inner 
splint can be obtained, tie legs and thighs together. 

Broken Knee-cap 

Symptoms.—As above, patient falls to ground and cannot 
raise leg. Not difficult to detect fracture, as can feel groove in 
knee-cap immediately beneath the skin. 

Treatment.—Services of a physician will be required and shock 
generally demands treatment. IMust also use care in moving 
leg. 

Straighten leg. Secure splint long enough to extend from 
middle of thigh to middle of lower leg. Preferably, this should 
be a thin board as wide as thigh, but a cane, umbrella or the 
like may be used in case of emergency. IMake pad for splint, 
apply splint to back of thigh and leg with middle opposite bend 
of knee and tie in place with strips of cloth or handkerchiefs. 
Be careful not to put bandage over break, but one strip im¬ 
mediately above andone immediately below knee. 

Fracture of Collar-bone 

Symptoms.—Patient supports elbow of injured side with hand 
of other side. Is unable to raise arm above shoulder. Is easy 
to feel depression by running finger over injured collar-bone. 

Treatment.—Send for doctor. Treat shock. 

jMake pad from a large handkerchief, two medium-sized 
handkerchiefs, a triangular bandage or the like. Place this pad 
in arm-pit of injured side. Put arm in sling with forearm at 
right angle to upper arm. 


42 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 



1. First Aid Dressing Applied 
Around Body for Broken Rib. 


3. Blanket Splint 
for Leg 




2. First Aid Bandage Around Hips 
for Broken Pelvis. 



4. Improvised 
Splint for 
Leg 


5. Improvised Splint for Arm. 


James FSrerfPr 


Plate VIII.—Fractures 
















































FRACTURE OF LOWER JAW 


43 


Take a bandage about 3 inches wide, put this horizontally 
around body and injured arm at elbow. It will, of course, en¬ 
circle both the elbow, the bent arm and the body. When tied, 
by pulling elbow to body it will force upper end of humerus 
outward, and thus prevent broken ends of collar-bone from 
overlapping. 

Another method: 

Have patient lie down and place his injured shoulder on pillow 
in a comfortable position till doctor arrives. 

Fracture of Ribs 

Symptoms. —Sharp pain on taking a long breath or coughing. 
Breathing is usually short, patient often presses hand to side to 
prevent movement of chest. 

May feel grating of ends of broken bones on each other by 
placing hand on chest at point where pain is most severe. 

Treatment. —Tie a large handkerchief or a triangular bandage 
firmly around the chest, pin a large towel snugly around chest 
or best apply a roller bandage to chest. These limit chest motion 
and thus diminish pain. 

If shock is severe, call doctor immediately. If not, after 
bandage is in place may visit a doctor as soon as practicable. 
Treat shock. 

Fracture of Skull 

Sjnmptoms. —Patient is probably unconscious from injury to 
brain. If at base of skull, there will probably be a discharge 
of blood from nose, ears or mouth. If at top of skull, fracture 
may easily be felt under skin. 

Treatment. —Send for doctor. Place in lying-down position 
with head slightly raised and keep very quiet until doctor arrives. 
Treat shock but no stimulants unless patient is very weak. 

Fracture of Lower Jaw 

Symptoms. —Mouth open, patient cannot speak. Fracture 
may often be felt outside, and inside there will be an irregularity 
of the teeth. May be bleeding from gums. Shock. 


44 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 

Treatment. — Send for doctor. Treat shock. 

Gently raise broken jaw and bring lower against upper teeth. 
Support in this position with the jaw^ bandage or with two 
strips of bandage, one vertical, tied over top of head and the 
other longer, brought to back of head, crossed and brought 
horizontally to forehead and tied there. 

Broken Back 

Symptoms. —Patient unable to move. No motion or feeling 
in body below injury. 

Treatment. —Send for doctor at once. If possible, do not 
move patient before his arrival. Treat shock. 

If patient must be taken from the spot where his injury has 
occurred, procure ample assistance to lift him. This should 
be done with the greatest care so as not to bend spine for this 
will crush spinal cord. 

Put stretcher under patient and gently lower him to stretcher. 

Fracture of Nose 

Symptoms. —Usually not difficult to detect. Pain, swelling, 
crepitus and deformity. Swelling may be so great that obscures 
deformity. Is not infrequently compound. 

Treatment. —Put in as natural position as possible and hold 
there with an adhesive-plaster strip across nose from cheek to 
cheek. Before applying plaster, put a small compress of gauze 
on each side of nose. If you have no adhesive plaster put on 
bandage over nose and around head, but do not pull tight enough 
to flatten nose. Consult doctor, as there is danger of permanent 
deformity. 


QUESTIONS 

1. What are the common injuries without a break in the skin? 

2. How may such injuries be prevented? 

3. Of what is the body composed? 


QUESTIONS 


45 


4. What is the skeleton and what does it do as a part of the body? 

5. Of what parts is the head made up? 

6. Into what two parts is the trunk divided and what does each 
contain? 

7. Describe the spinal column; the ribs; the breast-bone; and the 
pelvis. 

8. Of what bones is the upper limb formed? The lower limb? 

9. What is a joint? 

10. What movements do joints have? Give an example of a ball- 
and-socket and of a hinge joint. 

11. What are the muscles? 

12. What is the purpose of the muscles? 

13. What is the importance of muscles in reference to fractures and 
dislocations? 

14. What is the subcutaneous tissue? 

15. Describe bruises. 

16. What are the symptoms of bruises? 

17. How would you treat them? 

18. In a severe bruise what else must you look out for? 

19. What is a strain? How is it caused? What are the symptoms? 

20. What is the treatment? 

21. What is a sprain? How is it caused? Symptoms? Treat¬ 
ment? 

22. Is a severe sprain a slight injury? 

23. What is a dislocation? 

24. How are dislocations caused? Symptoms? Treatment? 

25. Under what circumstances would you be justified in trying to 
reduce a dislocation? 

26. When should you proceed to do so? 

27. Danger of attempts to reduce dislocation? 

28. Describe special treatment for dislocations of the lower jaw, 
finger and shoulder. 

29. What is fracture? 

30. What is a simple fracture? 

31. What is a compound fracture? Causes of simple fractures and 
of compound fractures? 

32. How would you prevent a simple fracture from becoming a 
compound one? 

33. How would you recognize a simple fracture? 

34. How would you treat a simple fracture? 

35. How would you recognize a compound fracture? 


46 INJURIES IN WHICH THE SKIN IS NOT PIERCED OR BROKEN 


36. Treatment of compound fracture? 

37. What is a splint? 

38. From what materials may a splint be made? 

39. Precautions in applying splints? 

40. Symptoms and treatment of fracture of the upper arm and fore¬ 
arm; of wrist; of fingers; crushed hand—foot; of the lower leg; the thigh; 
of knee-cap; of collar-bone; of ribs; of skull; of lower jaw; of back; 
of nose. 


PRACTICAL EXERCISES 

Show methods of treatment of dislocations of lower jaw, shoulder and 
fingers. 

Show methods of treatment of a simple fracture. 

Show application of splints in fracture of upper arm and forearm; 
wrist; fingers; crushed hand and foot; fracture of lower leg; the thigh; 
the knee-cap; collar-bone; ribs; skull; lower jaw; back; nose. 

Practise in bandaging and the application of splints. 


CHAPTER IV 


INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN: 

WOUNDS 

Injuries in which the skin is pierced or broken are called 
wounds. As will be seen, such injuries have certain dangers 
that other injuries are free from. In order to understand them 
it is necessary for the first-aid student to know of the protection 
afforded the body by the skin and of the action of certain germs 
on the body. 


The Skin 

Of course, everybody knows what the skin is. It is the cover¬ 
ing of the entire body. The skin is made up of different layers. 
The outside horny layer protects the body from the entrance 
of pus germs which are the very small parasites which cause 
inflammation, matter or pus and blood poisoning. Remember 
that these pus germs always come from outside the body and if 
the skin is unbroken they cannot enter it. In consequence any 
injury in which there is a break in the skin is liable to the addi¬ 
tional, and perhaps very great danger due to pus germs. 

The Germs 

The action of pus germs on the body is very important. The 
wonderful operations which modern surgeons are able to perform 
are entirely due to their knowledge of how to protect the body 
from the injurious effects of these germs. 

With an injury of the body from a mechanical or chemical 
cause the effect of the injury appears at once. With germs this 
is different, however. Everything looks all right at first and the 

47 


48 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 



1. Normal Section of Skin 
(magnified) 


2. Showing Clean-cut Wound 
Caused by a Sharp Instrument 


3. Wound Caused by a 
Blunt Instniment 



4. Infection by Handling, or Water 



5. How to Care For a Wound 
A Clean Dressing 


Plate IX. 






DESCRIPTION OF PLATE IX. 

I. NORMAL SECTION OF SKIN. 

(Magnified.) 

Note the upper horny_ layer. This protects the body from the en¬ 
trance of pus germs which are the very small parasites which cause 
inflammation, matter or pus or blood poisoning. 

2. WOUND CAUSED BY A SHARP INSTRUMENT. 

In a wound caused by a sharp instrument, while the protection of 
the skin is lost, comparatively few germs are carried into the wound. 
Most of these are washed out by the blood. The very slightly in¬ 
jured cells of the body are able to destroy many others. So such 
wounds are not as dangerous as ragged, torn wounds. No germs 
float in the air and there is no danger in exposing wounds to the air. 

3. WOUND CAUSED BY A BLUNT INSTRUMENT. 

With a blunt instrument many more germs are driven in. The 
bruising of the tissues of the body makes the cells much less able to 
destroy the germs and bleeding is not so free. So such wounds are 
much more likely to be followed by inflammation and the formation 
of pus or matter than are clean cuts. (Note. The germs have not 
been carried to the deeper parts of the wound.) 

4. INFECTION BY HANDLING OR WATER. 

If the wound is touched by the hand billions of pus germs will be 
carried into it. If washed with water even more germs will be carried 
into the wound and not only that, but the deep parts of the wound 
which previously no germs had reached will have billions of germs 
carried to them. Therefore do not handle or wash a wound. Even 
if an antiseptic solution is used it will carry pus germs from the skin and 
deeper than they have been before and no antiseptic such as bichlo¬ 
ride of mercury can be used strong enough to kill these germs, as it 
will then also destroy the cells of the body and so make them less able 
to fight the germs. Peroxide is specially dangerous in deep wounds 
as it carries pus germs everywhere and is not strong enough to destroy 
them. 


5. HOW TO CARE FOR A WOUND. 

Placing "a clean dressing, which means a dressing that has been 
sterilized surgically (such as the Red Cross Dressing) on the wound 
will introduce no more germs and will not injure the delicate tissues of 
the body, exposed in the wound. Moreover, the flow of blood and 
blood serum (the liquid part of the blood) will be in the direction of 
the dressing, so the germs will be constantly going out. 

This therefore, is the way to take care of a wound. 


4 


49 








50 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

bad effects only appear later with the growth of the germs and 
the production of their powerful poisons. 

These germs are so small that they can only be seen through a 
powerful microscope. What they lack in size they make up in 
numbers and they live outside of the body in countless millions. 
They do not float around in the air, so there is no danger from 
them in exposing a wound to the air. Pus germs are found on 
the surface of our bodies, on knives and other objects which cause 
wounds, in the dust of houses, in water, and also on surgical 
instruments and dressings unless special means have been taken 
to free them of germs or, in other words, unless they have been 
disinfected or sterilized. 


The Wound 

Suppose a wound is received, what happens? If pus germs do 
not gain entrance to it, there will be no inflammation and it will 
heal quickly and kindly; but if, on the other hand, the wound is 
infected by pus germs, this means that inflammation will follow, 
more or less matter will form, and there will be some absorption 
of poison from the wound which may result in the more severe 
forms of blood-poisoning and almost inevitable death. But as 
pus germs are so generally present, it might appear that under 
ordinary conditions they would always be carried into a wound 
when it is received, either from the surface of the body or by 
the object which caused the wound. This is true, but if only a 
few pus germs are so carried into the body certain cells there will 
dispose of the germs without trouble and no harm will result; 
moreover, unless too many pus germs are carried into the body, 
the blood resulting from the injury will often wash so many out 
that the cells can dispose of the few left with little difficulty. 
This is exactly the reason why a wound which bleeds freely is 
less likely to prove dangerous. We should conclude, then, that 
every wound is not infected with pus germs and must use every 
care not to infect it by our hands, by water, dressings or anything 
else. 

The symptoms of inflammation in a wound are heat, redness. 


VARIETIES OF WOUNDS 


SI 

pain, swelling and partial or complete loss of use of the wounded 
part. These are the signs of wound infection and if these appear 
in a wound three or four days after an injury, unless they are 
slight a doctor is necessary, as they may grow much worse. 

While the breaking or piercing of the skin is what distinguishes 
wounds from other injuries, in wounds there is also, of course, 
more or less damage to the parts of the body beneath the skin. 
As blood-vessels are found practically everywhere in the body 
they are always injured in a wound and some bleeding results. 
Usually—in about ninety-nine cases out of a hundred—this 
bleeding is not severe and may be checked by the pressure of an 
ordinary wound dressing. In nearly all wounds therefore what 
we must specially look out for is to prevent germs getting in. 

Varieties of Wounds.—i. Cut or incised wounds, in which 
the skin and underlying tissues are cleanly divided by a sharp 
instrument. They are caused by razors, sharp knives, glass and 
the like. In this variety of wounds, as blood-vessels are cleanly 
cut across, there is likely to be severe bleeding. 

2. Torn or lacerated wounds, in which the tissues are torn 
rather than cut. They are caused by a tearing or crushing 
injury, such as the blow of a blunt instrument, by machinery 
or by being run over or struck by a wagon, trolley or railway 
car. With them, as the blood-vessels are crushed as well as the 
other tissues, severe bleeding is not nearly so likely to occur as 
in the preceding variety, but on account of the character of the 
injury, dirt is likely to be ground into the tissues and they are 
so extensively torn and destroyed that infection followed by 
inflammation and matter or pus is extremely common. 

3. Punctured wounds are deep wounds of small size produced 
by sharp-pointed instruments, such as daggers, bayonets and 
the like. Wounds caused by bullets are also included in this 
class. Wounds of this variety are, of course, frequently pur¬ 
posely inflicted, but the great majority of bullet wounds in civil 
life result from carelessness which is almost, if not quite, criminal. 
“I didn’t know it was loaded” is not sufficient excuse for shooting 
a fellow-being, and if one observes the rule of never point¬ 
ing a gun or pistol at himself or at anyone else he will have 


52 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

no occasion to make this excuse. The amount of bleeding in 
this variety of wounds is often slight, but may be great if a large 
blood-vessel is injured. Infection is not uncommon, as pus 
organisms when carried into such wounds are best situated to 
increase in numbers. 

Symptoms of Woimds. —The wound itself. Pain. Bleeding. 
Shock. 

Treatment of Ordinary Woimds. —(This refers to the vast 
majority of wounds in which as previously noted bleeding is 
slight. For the treatment of severe bleeding see next chapter.) 
In deep wounds or those which cover a considerable surface, 
always send for a doctor at once. It is always better to call in 
a physician if you doubt your ability or resources. Treat shock. 
In all wounds if necessary cut or rip clothing so as to get a view 
of the wound. Turn back the clothing so it does not touch 
wound. Do not touch wound yourself nor allow the wounded 
person to touch it. Remember there is no hurry, for air will not 
infect the wound. If a physician may be expected to arrive 
within a few moments, it will usually be necessary to do nothing 
further. Exposure to the air is much safer than the application 
of anything which is not surgically clean or antiseptic. If, 
however, you have a surgically clean or antiseptic wound dress¬ 
ing, apply it to the wound at once and bandage firmly into place. 
This will prevent accidental contamination and will usually 
stop any bleeding there may be. 

Water is dangerous as it contains many pus germs. Strong 
antiseptics such as bichloride of mercury or carbolic acid will 
destroy the cells of the body which dispose of the pus germs be¬ 
fore they kill the latter and should never be used. Peroxide of 
hydrogen is not strong enough to kill germs and in a large or 
deep wound it washes them to uninfected parts which then be¬ 
come infected. Therefore, use none of these things but cover 
the wound to keep out pus germs. 

What has been said applies to all kinds of wounds and the treat¬ 
ment given is a good one for the little cuts or scratches which are 
so common. But these, especially if they do not go through the 
skin, are rarely dangerous. We do hear from time to time of 


WOUND DRESSINGS 


53 


some one dying from blood-poisoning as the result of the scratch 
of a pin but many thousand such slight injuries are received 
which are recovered from with or without treatment. Inflam¬ 
mation of these slight wounds is not particularly uncommon, 
however, and this should be prevented if possible. They rarely 
bleed much and making them bleed so that the blood will wash 
out the germs is the best thing to do first. Do not suck them as 
very dangerous pus germs are found in the mouth. Squeeze 
them well at the sides. With a finger it is well to encircle the 
finger near the hand with the thumb and finger of the other hand 
and then to work down with strong pressure, pushing all the 
blood in the finger ahead of the encircling thumb and finger of 
your other hand. This is sometimes called milking the finger. 
After the blood has been squeezed out a piece of clean gauze 
makes an excellent dressing. These small wounds may be safely 
washed with peroxide before a dressing is put on as with them 
there is no danger of pus germs being washed into deep parts. 
Collodion may safely be used on a shallow, cleanly cut wound but 
if the wound becomes inflamed it must be removed as this shows 
pus germs have been sealed up and are multiplying and produc¬ 
ing poison. The use of plaster (except court plaster to cover a 
trivial scrape not involving the entire thickness of the skin) 
must be absolutely condemned, for not only does plaster seal 
the wound so any germs within will be in most favorable posi¬ 
tion to increase in numbers but is itself likely to be covered with 
pus germs. 

More about Wound Dressings. —A wound dressing consists 
of everything which is used to cover or to dress a wound. The 
pad which is put directly on the wound is called a compress. 
In ordinary emergency treatment a bandage is put on immedi¬ 
ately over the compress and this is all that is necessary. With 
much bleeding it is better, if you have it, to put a layer of absor¬ 
bent cotton over the compress and then to bandage. It is 
important that the compress should not only be large enough to 
cover the wound but to lap an inch or so on each side. Do not 
forget that the compress is the most important part of the dress¬ 
ing. It is the inside we are looking after, not the outside and a 


54 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

beautifully applied bandage will not make up for a dirty or 
poorly applied compress. 

Surgeons commonly say dressing materials are clean or dirty. 
They mean surgically clean for the former, that is to say, the 
germs in them have been killed by some means. Every material 
is dirty in the surgical sense if the germs have not been killed. 
Surgically clean, sterile, or antiseptic dressings as they are vari¬ 
ously called are, of course, the only kind that should be applied to 
wounds. 

Most things required by the first-aider can be made. As will 
be seen, however, the process of making good wound compresses 
is complicated and it is much safer to have such articles ready 
at hand. 

Of course it not only is necessary that the germs be killed at 
the time a wound compress is made but when it is put on the 
w^ound that it has not been contaminated in the meantime and 
that it can be handled at that time without being contaminated. 

The necessity for a safe dressing for wounds led to the making 
of the American Red Cross First-aid Outfits. 

In each of these outfits is found a long gauze bandage with a 
compress of gauze sewn to it in the center, a triangular bandage 
printed so as to show how to apply it, and two safety-pins. 

The directions, which are also found inside the case, are as 
follows: 

Gauze Bandage with Compress .—If there is a wound or any 
injury in which the skin is broken, this bandage and compress 
are used by unfolding the bandage, being careful not to touch the 
inner siudace of the compress. The compress should then be 
placed directly on the wound or injury, and held in place by wrap¬ 
ping the ends of the bandage around the limb in opposite direc¬ 
tions and tying them or pinning them in place. With a very 
large wound which the compress wall not cover, apply it to the 
middle of the wound and WTap the bandage around as before. 
In this case be careful not to touch any surface of the bandage 
which is placed on the wound. In case there is no w'ound, this 
bandage may be used like an ordinary bandage to hold splints 
in place, etc. 


WOUND DRESSINGS 


55 


1, The Dressing is Free from Germs. The 
operator is careful not to touch the surface 
wluch will cover the wound. 



6. How to Dress a Wound 



FIRST AID OUTFIT 

MAOe eSPCC/ALlY rOH 

Red Cross 

BAVEH & BEACH, 
CHiCACO, V.S.A. 

—irc><r=- 

TO OPEN PULL THE P/NO « 

PATCHTAPPLICO rOR 


NOTE. This Dressing is 
hermetically sealed and is 
protected from any acci* 
dental contamination be* 
foKe being used, so that you 
KNOW it is safe to put on 
a wound. 


7, Red Cross First-Aid Outflt 






8. Red Cross First-Aid Outfit 

(Sbowing Cmlents) 


A Compress is Sewed in the middle of a 
long bandage which is so folded that it is im¬ 
possible to touch the surface of the compress 
which will cover the wound except through 
gross carelessness. 


9. How to Apply Red Cross Compress 


Plate X.—Surgical dressings. 































56 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

Triangular Bandage .—The triangular bandage may be used 
as an outer bandage or as a sling in the manner pictured on it. 
This bandage should also be tied or pinned in place. 

“ Do not touch an open wound with the fingers, water, or any¬ 
thing except the compress, or when very large the untouched 
surface of the bandage. 

“The pressure of the bandage will stop ordinary bleeding.” 

The advantages of this outfit are that the contents are always 
clean and ready for use, the dressing may be easily applied, and 
not only does it contain a dressing, but also a sling. With it 
and materials for splints which may usually be easily obtained 
you are ready for any ordinary injury. 

A number of other first-aid packets are on the market which 
contain compresses that may be safely applied to a wound, 
though none is quite so easy to handle without accidental con¬ 
tamination as the Red Cross outfit. Each has printed directions 
on the box or container which must be carefully followed. 

If a first-aid packet can be procured it should always be used 
in preference to anything else to dress a wound. The next 
choice should be sterile or antiseptic gauze. Small packages of 
such gauze suitable for compresses may be bought in most drug 
stores, and are found in emergency cases. (Sterile gauze is 
ordinary gauze in which the germs have been destroyed by heat, 
and antiseptic gauze is ordinary gauze in which germs have been 
destroyed by an antiseptic, usually bichloride of mercury.) In 
a city, therefore, or if an emergency case is available, one may 
easily procure a safe compress and all he need do is to handle it 
so that he will not contaminate it. This may be accomplished 
by holding it not with the fingers, but by the paper which covers 
it, allowing only the inner surface of this paper to come in contact 
with the gauze and never removing part of the paper until it has 
served this purpose. If, by chance, the gauze is touched by the 
hand great care should be taken to drop the untouched part on 
the wound and to place the gauze which has come in contact 
with the hand as near the outer layer of the compress as possible. 

As stated, unless a safe gauze can be procured it is much safer 
to leave a wound exposed to the air than to cover it, but this will 


WOUND DRESSINGS 


57 


not always prove practical. It is especially in places where 
no gauze for compresses can be procured that circumstances 
render it necessary to cover wounds. In such localities it may 
be hours before the services of a doctor can be procured, so an 
uncovered wound will be exposed for a long time to accidental 
contamination, which will be almost inevitable from the hands 
or clothing of the injured person who must perhaps be moved. 
A compress, too, affords an excellent means of checking bleeding, 
being often all that is required for this purpose. 

Under such circumstances, therefore, it will be necessary to 
make a compress which, if not as safe as is desirable, is, at least, 
as good as can be procured. First, as surgically clean cloth for 
the compress as can be obtained should be used. This will be 
found in a towel, a handkerchief or other cloth of the same kind 
which has recently been laundered and has not been used since 
it was washed. Preferably, this cloth should be boiled for ten 
minutes or soaked in a solution of i-iooo bichloride of mercury, 
corrosive sublimate, for an equal length of time. (Tablets of 
corrosive sublimate are in common use; they are known as anti¬ 
septic tablets. This substance is a deadly poison and its solu¬ 
tion cannot be made in metal vessels.) The process recom¬ 
mended will give a compress which is safe to use, but an impor¬ 
tant practical difficulty is presented in applying such a compress 
to a wound. It will, of course, be so wet that it will not be 
possible to put it on the wound without squeezing some of the 
water out of it. To do this the compress must necessarily be 
handled and, as has been explained, pus germs exist in countless 
millions on the hands. 

If possible, the hands must be cleaned surgically, which means 
they should be freed of germs. This should be done by hard 
scrubbing for five minutes with hot water, soap and a nail¬ 
brush, paying special attention to' the nails. Preferably the 
hands should be washed under a tap instead of in a basin, and 
if a basin is used the water had best be changed two or three 
times. As a further precaution, when corrosive sublimate is 
procurable, the hands after being washed should be soaked in a 
i-iooo solution of that chemical for a period of five minutes. 


58 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

The hands must not be wiped and they must not touch anything 
except the compress. The piece of cloth which is intended for 
a compress may now be taken from the vessel in which it has been 
boiled or disinfected, but in so doing the operator should be 
very careful not to allow his hands to touch that part of the com¬ 
press which he intends to put on the wound. On the contrary, 
he should pick up the piece of cloth by its* outer surface and, 
holding it at all times by this, squeeze the w^ater from it until it 
is comparatively dry and then put it on the w^ound without 
delay. If a fairly large piece is taken for the compress and if, 
previous to boiling, or disinfection, it is folded so as to fit the 
w^ound it will be handled much more easily and safely. 

When no facilities are available for washing and disinfecting 
the hands, this naturally must be omitted, but the same precau¬ 
tions should be taken in handling the compress. Suppose, how¬ 
ever, that in addition the compress cannot be boiled or disin¬ 
fected, and yet it is absolutely necessary to have one. In this 
case one should again take a towel, handkerchief, etc., which 
has just been laundered, and without unnecessary handling 
apply its inner surface to the wound. Towels, handkerchiefs, 
etc., which have been used or handled, though they may look 
clean, are never so in the surgical sense and are therefore particu¬ 
larly dangerous to use as compresses. 

Special Wounds 

Abdominal Wounds. —All wounds should be treated on the gen¬ 
eral principles already described. A w^ord or two is required, 
however, on the subject of abdominal wounds in which more or 
less of the abdominal contents escape through a large cut. 
Send for a doctor at once. Place a clean cloth over the wound 
and keep it constantly wet with a weak solution of salt and water, 
for if these delicate structures become dry they will suffer almost 
fatal damage from this cause alone. Boiled water is the only 
safe water to use for this purpose but if you cannot boil the water 
you will have to use the cleanest water available. Treat shock. 

Wounds in which Foreign Bodies Remain. Treatment.— 
Such bodies should be gently pulled from the wound in a direc- 


EYE WOUNDS 


59 


tion contrary to that in which they entered. If they are of 
considerable size and have damaged the tissues a good deal, the 
wound should be shown to a doctor at the earliest opportunity. 

With a splinter of wood, the commonest of such foreign bodies: 
Pull the splinter from the wound with a pair of pincers 
or by putting a knife blade against it and holding it on the 
blade with the thumb-nail. 

The same method may be used with a splinter under the 
nail. But if it is broken under the nail, scrape the nail thin 
over it and cut out a small V^-shaped piece so as to reach it. 
Small splinters in the skin may be removed by a needle. 
In order to avoid possible infection it wall be much safer 
to wash the skin with hot water and soap and to pass the 
needle through a flame before using it. 

A wound from which a foreign body has been removed should 
never be sealed with plaster or collodion. 

Eye Wounds, Including Foreign Bodies in the Eye.—The 
eye is the organ of sight. It is a ball surrounded by three coats. 
Covering the eyeball in front is a delicate membrane called the 
conjunctiva. Protection to this membrane is afforded by the 
eyelids when they are closed, but when they are open it is very 
liable to injury and to the entrance of foreign bodies. These 
are commonly spoken of as “something in the eye.’’ On account 
of the sensitiveness of the conjunctiva, they cause much pain and 
distress. The eyeball itself is well protected from injury, as 
it is situated deeply in the head and the brows overhang it. 
Pointed objects may, however, enter it. When this occurs 
severe damage almost always results. 

The symptoms are severe pain and redness of the eye, and if 
a wound has been inflicted it is usually easy to see the cut. Such 
injuries should be treated by a doctor. Therefore, in any injury 
of the eyeball, cover both eyes with absorbent cotton or soft 
cloths, soaked in cool water, so as to keep the eyelids still, and 
bandage them into place with bandages around the head. Be 
careful not to put on these bandages so tightly that they will 
press on the eyeballs, and in order to prevent inflammation keep 
them constantly wet with cool water until the services of a doctor 


6 o INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

can be procured. While boiled water is safer for this purpose 
there is little danger in the use of any clean water. 

Splinters in the eye should be pulled out if possible. If they 
cannot be removed, put a few drops of olive or castor oil in the 
eye. Whether removed or not, the e>es should be treated in the 
manner just described and a doctor should be consulted as soon 
as possible. 

Foreign bodies in the eye are usually cinders, sand or particles 
of dust. They cause a great deal of discomfort and pain, and 
tears, which, fortunately, often wash them out. 

Never rub the eye, as this will be likely to rub the foreign body 
into its delicate covering. 

First, close the eye so that the tears will accumulate and the 
foreign body will frequently be washed out or into view, so that it 
may be easily removed. If this fails, pull the upper lid over the 
lower two or three times, close the nostril on the opposite side 
with the finger and have the patient blow his nose hard. 

If the foreign body still remains in the eye, examine first under 
the lower, then under the upper lid. For the former, have the 
patient look up, press the lower lid down and if the foreign body 
is seen brush it off with the corner of a clean handkerchief. The 
upper lid is not so easy to see. Seat patient in a chair with his 
head bent backward. Stand behind him and place a match 
across the upper lid one-half inch from its edge. Turn the upper 
lid up and back over the match and brush off the foreign body as 
before. A few drops of castor oil in the eye after removing a 
foreign body will soothe it. 

Above all things do not be rough, however, or you may do 
very serious injury. If you experience any difficulty in removing 
any speck from the eye it is much safer to bandage a pad wet with 
clean water on it and to take the patient to a doctor. 

Lime in the eye may be neutralized by bathing it with a solu¬ 
tion of vinegar, a teaspoonful to a cupful of water. Particles of 
lime large enough to be seen should be removed like other foreign 
bodies. 

Poisoned Wounds. —This name is given to wounds into which 
a poison other than pus germs is introduced. Special treatment 


SNAKE BITE 


6l 


is necessary in order to remove and combat the effects of this 
poison on the body. Snake bite, bites of dogs and cats, lockjaw 
and stings and bites of insects and spiders will be discussed here. 

I. Snake Bite 

Snake bites are rare injuries in this country, but bites from 
poisonous snakes are so rapidly fatal if not promptly given 
proper attention that it is necessary for the student of first aid 
to know how to treat them. The rattlesnake and the moccasin 
are probably most generally to be feared in the United States. 

Prevention. —When it is impossible to avoid the localities 
where poisonous snakes are commonly found, comprises the 
wearing of high boots or leggings by day and sleeping on a cot 
or raised platform at night instead of on the ground. The 
Mexican plan when sleeping on the ground of surrounding the 
sleeper with a hair rope or lariat is undoubtedly a good one, as 
snakes will not cross such a rope. 

Symptoms. —Great pain in the wound. Rapid swelling. 
Much depression and weakness, followed promptly by death in 
some cases unless proper treatment is given. 

Treatment. —Immediately tie a string, handkerchief or band¬ 
age between the bitten part and the body if this is practical. 
Naturally, this can only be done in the limbs. This cutting off 
of the return of the blood to the body, of course, prevents absorp¬ 
tion of the poison. The wound should then be soaked in hot 
water if this is obtainable and in any event squeezed, milked, 
or sucked. This is for the purpose of extracting as much poison 
as possible. Sucking the wound is not dangerous unless one has 
cuts or scrapes in the mouth. These procedures should not be 
delayed for a moment in order to send for a doctor but one should 
be summoned as soon as possible. The further first-aid treat¬ 
ment consists of burning or cauterizing the bite with ammonia. 
Strong ammonia should be used for this purpose. The patient 
should also be dosed with stimulants. It is not necessary to 
give whisky or brandy so as to intoxicate him. But a large 
drink of whisky or brandy or a big dose of aromatic spirits of 


62 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 

ammonia should be given at once and should be repeated as often 
as seems necessary to keep up the strength. Do not be afraid 
to give too much, for persons bitten by poisonous snakes require 
a large amount of stimulants. 

Leave the string or bandage tied above the wound in place as 
long as you dare. After an hour, however, you must remember 
your tight bandage is likely to cause mortification as it has cut 
off the circulation. It must therefore be loosened. Never try 
to remove it all at once but loosen it a little so that only a small 
amount of poison will be carried into the body, then tighten and 
repeat after a few moments if the patient does not seem to be 
greatly affected by the poison. In this way you may finally be 
able to remove the constricting band entirely. But, on the other 
hand, if the poison which escapes into the body seriously depresses 
the patient you must keep the bitten part tied off and take 
chances on mortification. 

2. Dog and Cat Bites 

The teeth of a dog, and to a less extent those of a cat, make a 
rather nasty lacerated wound. These are treated like all other 
similar wounds unless the biting animal is rabid or is suspected 
of being rabid. Rabies is, of course, the same as hydrophobia. 
Cows, horses, wolves, foxes and deer also have hydrophobia. 

The first thing to do for such a bite is exactly like that for 
snake bite: tying off, hot water and squeezing to encourage 
bleeding, and then burning. Of course a red hot wire may be 
used for burning the wound as well as strong ammonia or nitric 
acid. Lunar caustic, though so commonly used, is not of much 
• value. 

As soon as the bite has been cauterized, remove the constricting 
band and dress like any wound. Treat shock. 

When possible it is best to have a doctor see such bites at once. 
But in any event you should never neglect consulting him as 
early as practical on account of the dangers of hydrophobia, 
which is a terrible disease that may be easily prevented but is 
never cured. 


STINGS AND BITES OF INSECTS 


63 


3. Lockjaw 

The scientific name for this is tetanus. It is due to a special 
germ which takes time to develop in the body so just as with 
pus germs nothing wrong is noticed immediately after a 
wound is received. The point to be remembered is, how¬ 
ever, that lockjaw can be prevented by proper treatment but 
that it is almost never cured. Lockjaw develops particularly 
in ragged torn wounds into which dirt has been ground and 
sometimes in wounds due to rusty nails. It is much safer to 
have a doctor see such wounds as soon as possible. 

4. Stings and Bites of Insects and Spiders 

These are rarely dangerous to life, though they may cause a 
great deal of pain and discomfort. Ammonia should be imme¬ 
diately applied to the part where the sting entered; this should 
be removed if it remains in the wound. Afterward cool, wet 
dressings should be used. Cloths wet with water in which a very 
few drops of carbolic acid have been thoroughly mixed, wet 
salt, and wet earth are all good applications. 

QUESTIONS 

1. What is a wound? 

2. What is the special danger to be feared in a wound? 

3. How does the skin protect the body? 

4. What is the difference in the effect produced on the body by a 
mechanical or a chemical cause and by germs? 

5. How can* a germ enter the body? 

6. Where are the germs found? 

7. What does disinfection mean? 

8. What happens in a wound if germs gain entrance to it? If they 
do not gain entrance to it? 

9. How does free bleeding diminish the danger of wound infection? 

10. What is inflammation? 

11. What is blood-poisoning? 

12. How would you prevent pus germs entering a wound? 

13. What are the symptoms of inflammation in a wound? 


64 INJURIES IN WHICH THE SKIN IS PIERCED OR BROKEN 


14. When do they come on and what should you do if they appear? 

15. What are the varieties of wounds? 

16. What are the symptoms of wounds? 

17. How would you treat an ordinary wound? 

18. Why should one try to make a trivial wound bleed? 

19. What dressing would you prefer to use for a wound? 

20. How would you prepare a wound dressing? 

21. State what you know of the use of: Strong antiseptics; peroxide 
of hydrogen; collodion; plaster. 

22. What is the treatment for an abdominal wound? 

23. What do you understand by foreign body? 

24. How would you treat a wound in which there is a foreign body? 

25. How do you treat an eye wound? 

26. How would you remove a speck from the eye? 

27. What are the dangers in removing foreign bodies from the eye? 

28. What are poisoned wounds? 

29. What would you do for a snake bite? 

30. What is hydrophobia and how is it caused? 

31. What is lockjaw? How is it prevented? 

32. What is the treatment of bites and stings? 

PRACTICAL EXERCISES 

1. Show wound dressings and their method of application. 

2. Have each member of the class put on such a dressing in such a 
way that neither the dressing nor the wound is contaminated. 

3. Show how to treat a snake bite. 

4. Show the way to remove a foreign body from the eye. 


CHAPTER V 


BLEEDING 

As stated under the head of wounds in ninety-nine cases out 
of a hundred exposure to the air or the pressure of the dressing 
is all that is necessary to stop bleeding. Do not become hurried 
or alarmed when there is a little bleeding but, on the other hand, 
remember that if much blood is being lost you must check it 
promptly or the injured person may soon be beyond human aid. 
In order that one may know how to stop severe bleeding it is 
necessary to know something of the heart and the blood-vessels, 
of the course of the blood and of the blood itself, and these will 
now be described. 

The Heart. —In order that the blood may reach all parts of the 
body it is, of course, necessary that some force shall propel it. 
This is provided by the Heart, which is not the seat of the feel¬ 
ings, but a most skillfully devised pumping machine. 

The heart is about the size of a man’s fist and is located in the 
chest between the lungs. It is a hollow, muscular organ, with 
valves which close and prevent the blood from flowing back¬ 
ward, all its force being expended to send the blood forward. 
The beat of the heart which w'e feel in the chest is its contraction 
by which it is made smaller inside, thus forcing the blood to the 
furthest parts of the body. After the heart contracts it dilates 
or becomes larger inside and the valves open so that it may fill 
w'ith blood. The next contraction again forces the blood for- 
w^ard, and so on as long as a person is alive. 

The heart contracts usually about 72 times per minute. 

While, as has just been stated, the heart is a pump, it is not a 
single but a double pump, being divided into tw^o entirely sepa¬ 
rate halves by a muscular partition. The left side of the heart, 
5 65 


66 


BLEEDING 


or the left pump, drives the blood through the body, and the right 
side drives it through the lungs alone. 

Blood-vessels. —A series of closed tubes, or blood-vessels, 
as they are called, carry the circulating blood. They are of three 
classes: i, Arteries; 2, Capillaries, and 3, Veins. 

I. Arteries. —^Leaving the left side of the heart is the largest 
artery in the body—the Aorta. This strong tube is just about 
large enough so that a man’s thumb may be introduced into it 
when it is separated from the heart. It soon divides into 
branches which again branch and rebranch, the branches con¬ 
stantly growing smaller in size, to reach finally the furthest parts 
of the body. It should be remembered, too, that the smaller 
branches of the arteries join freely with one another. The 
blood passes from the heart to the aorta and thence to the smaller 
arteries, not in a steady stream but in weaves, each of w^hich is 
produced by a contraction of the heart. The beat of these waves 
causes the Pulse, w^hich may be felt not only at the wTist and 
temple, but also anywhere else an artery is near enough the sur¬ 
face of the body. Naturally, if an artery is cut, there will not 
be a steady stream flowing from it, but the blood will be expelled 
in spurts or jets. Arteries, especially those of large size, remain 
open when divided. 

As the course of the blood in the arteries is away from the heart 
toward the limbs and the head, if an artery is cut, in order to 
stop the bleeding the artery must be compressed either on the 
side of the heart or on the bleeding point itself. Pressure on the 
further side of the cutwill, as may be easily understood, do no good 
so far as stopping bleeding from an artery is concerned. It is also 
necessary to press on the artery on the near or heart side as close 
to the bleeding point as possible. This is because arteries in 
their branching and re-branching join each other, and if pressure 
is made on any artery far above the bleeding point, so many 
branches may bring blood into it between the point of pressure 
and the bleeding point that a great deal of blood will be lost, 
notwithstanding the fact that the main branch is blocked by 
pressure at a distant point. However, it is not in every part 
of the body that arteries lie near enough to the surface to be 


ARTERIES AND PRESSURE POINTS 


67 


















68 


BLEEDING 


compressed in their course. Moreover, it is necessary in com¬ 
pressing an artery to select a point where a nearby bone gives 
a hard surface to press against. Therefore, the student of first 
aid must know, first, the situation and course of the principal 
arteries and, second, the points on which pressure will be effective. 

The aorta has three great branches which are of particular 
interest to the student of first aid. One of these, the Carotid, 
supplies the head and neck with blood; the second, the Sub¬ 
clavian, the upper limbs; and the third, the Femoral, the lower 
limbs. 

The table which follows gives certain necessary information 
regarding these arteries and their branches. 

Arterial bleeding is always more serious than other bleeding 
because blood is so rapidly lost being forced from the cut artery 
in jets with every beat of the heart. The blood which spurts 
from an artery is always bright red in color. 

2. Capillaries. —The arteries, as they go further and further 
from the heart, become smaller and thinner-walled, till they 
finally end in still smaller vessels which are called capillaries, 
from the Latin word meaning a hair. The capillaries form a deli¬ 
cate network of vessels everywhere, and give the rosy color to 
the skin. Slight pressure on the skin will cause a white spot to 
appear. This .is because the pressure has forced the blood from 
the net-work of capillaries and the white skin is seen instead of 


Head and Neck 


, Artery 

Course 

Point on which to 
make pressure 

Carotid. 

From upper, outer 

Deep. Down and back. 


edge of breast-bone 

an inch to the outer 


to angle of jaw. 

side of Adam’s apple. 

Temporal (a branch of 

Upward, one-half inch 

On skull, immediately 

carotid). 

in front of ear. 

in front of upper part 
of ear. 











ARTERIES 


69 


Artery 


Subclavian 


Brachial (a branch of 
a branch of the sub¬ 
clavian). 


Upper Extremity 


Course 


Across the middle of 
first rib to arm pit. 


Descends along inner 
side of big muscle at 
front of upper arm; 
about line of seam of 
coat, to just below 
center of crease at 
bend of elbow. 


Lower Extremity 


Point on which to 
exert pressure 


Deep. Down and back 
over center of collar¬ 
bone on first rib. 
Shoulder should be 
drawn down first. 

Against bone of upper 
arm by grasping and 
pulling big muscle to 
outer side. Or at 
elbow by putting a 
tight roll of cloth or 
a rolled bandage in 
bend of elbow, and 
bending up arm as 
much as possible. 


Femoral 


Popliteal (a continua¬ 
tion of the femoral). 


Down thigh from 
pelvis to knee, line 
from middle of line 
between point of hip 
and center of pelvis 
in front to inner side 
of knee. 

Down in middle of 
space at the back of 
knee-joint. 


Against bone of thigh 
high up inner side in 
line given about three 
inches below upper 
end of line. 


In bend of knee as 
described for elbow. 


the rosy color due to the presence of the blood in the capillaries. 
In capillaries the pulse, or contraction wave from the heart, is 
no longer apparent, as these fine, hair-like tubes break up the 
waves. Slight cuts or pricks of the skin divide some capillaries 




















70 


BLEEDING 



Plate XII.—Stopping bleeding. 

















THE BLOOD 


71 


and therefore cause bleeding. Naturally, on account of the 
minute size of these vessels, bleeding from them, except from a 
very large surface, is not dangerous to life. Capillaries branch 
so freely that pressure used to check capillary bleeding, to be 
effective, must be made on the bleeding point. 

The blood lost from capillaries is no longer bright red in color 
like that from arteries, but is somewhat darker. 

3. Veins.—The blood-vessels which return the blood to the 
heart from the points furthest from it are called veins. They 
may be easily recognized as the blue lines under the skin. Cap¬ 
illaries unite to form small veins, these unite to form larger veins, 
and finally these vessels become very large before entering the 
right side of the heart. The best known of the large veins is 
probably the jugular vein of the neck. 

Bleeding from a cut vein is in a continuous flow instead of in 
jets as is the case with bleeding from arteries, and it is mainly 
through this difference that one distinguishes venous from arterial 
hemorrhage. Venous blood, too, is dark, bluish-red in color, 
as the oxygen in the blood is lost in its passage through the 
capillaries. While bleeding from veins has not the almost 
terrifying appearance of arterial bleeding, a dangerous amount of 
blood may be lost from a large vein. As the course of the blood 
in the veins is toward the heart, in stopping bleeding from them 
pressure must never be made on the side toward the heart, but 
on the bleeding point or on the side away from the heart. 

The Blood.—The blood is a fluid which carries properly pre¬ 
pared food, oxygen, and heat to feed and warm all parts of the 
body, from which it also removes waste materials for final expul¬ 
sion. These processes go on constantly as long as life lasts. 
Coagulation or clotting is the property of the blood which is of 
most interest to the student of first aid. While the blood is 
circulating in the living vessels it remains fluid, but as soon as this 
influence is removed it coagulates or clots, thus tending to stop 
bleeding. It is easy to see if Nature did not provide this safe¬ 
guard that the slightest scratch sufficient to draw blood would 
result in the loss of all the blood in the body. The rate of loss 
would be regulated simply by the size of the opening just as is 


72 


BLEEDING 


that of water flowing from a pipe. Very rarely a person is 
found whose blood does not clot. These people are called 
“bleeders,” and they often bleed to death from a trivial injury, 
such as the pulling of a tooth. 

All efforts to stop bleeding have as their object clotting of the 
blood so that the clots will plug the bleeding vessels. Therefore, 
we must know the best way to help the clots to form. In order 
to clot, blood must be at comparative rest. A spouting stream of 
blood will never clot. This is one reason why bleeding from 
arteries is particularly dangerous. As soon as we stop the bleed¬ 
ing the blood begins to clot but not before. Any foreign material, 
especially if it has many points on which clots may form, will help 
in the formation of clots. Surgical gauze is a good example of 
such a material. Cobwebs are also, and they were much used even 
by surgeons before the danger of dirt in a wound was so well 
understood. 

Symptoms from Loss of Blood. —Besides the actual appearance 
of blood in hemorrhage, the loss of a considerable amount of blood 
gives rise to certain symptoms: Faintness, with cold skin, pale 
face, dilated pupils, feeble, irregular breathing, sighing, weak 
pulse, dizziness and loss of consciousness. The severity of the 
symptoms depends on how much and how rapidly blood is lost. 

Treatment of Wounds with Severe Bleeding. —Check the 
bleeding. Put the injured person in such a position that he 
will be least affected by the loss of blood. This is lying down with 
the head low so that the brain will get as much blood as possible. 
Do nothing which will increase bleeding. Violent movements 
must be prevented. When once the bleeding has ceased the 
injured person should remain quiet, as any movement may 
dislodge the clot and start it again. See that the patient gets 
plenty of good air, cover him warmly and put hot bottles around 
him if they can be obtained. Naturally, stimulants increase 
the force of the heart, so they are undesirable; but sometimes the 
injured person becomes so weak that it is absolutely necessary to 
give them to prevent him from dying. Whenever possible, 
always avoid doing so until the bleeding has been checked by 
some mechanical means. One-half teaspoonful of aromatic 


WOUNDS WITH SEVERE BLEEDING 


73 



Plate XIII.—Bleeding. 










74 


BLEEDING 


spirits of ammonia in a tablespoonful of water or a tablespoonful 
of whisky are good stimulants. 

When a patient is in a state of collapse from loss of blood his 
death may often be prevented by forcing the blood into the body 
from the limbs. This is done by raising the feet and bandaging 
the legs from the toes to the body and by bandaging the arms 
from the tips of the fingers to the arm pits. 

In order to check bleeding it is necessary to know from which 
kind of a blood vessel it comes. 

1. Arterial hemorrhage is recognized by bright red blood 
expelled in jets. The blood is lost very rapidly. 

2. Venous hemorrhage is recognized by a steady flow of dark 
blue blood. 

3. Capillary hemorrhage is characterized by the oozing of 
blood of a brick color. 

Hemorrhage will not be severe except from arteries and large 
veins. 

Naturally, as arteries, capillaries and veins may all be cut in a 
wound, there may be bleeding from all three. In this case 
afterial hemorrhage demands first consideration, and with 
venous and capillary hemorrhage the latter may be disregarded 
for the time being. 


Arterial Hemorrhage 

Treatment. —Send for a doctor at once. Do not wait for him, 
for by so doing the patient may die or be in a hopeless condition 
when he arrives. If necessary, cut off clothing at once so as to 
see bleeding point. In very severe bleeding take the next step 
before doing this. Press with your fingers or thumb on the artery 
between the bleeding point and the heart. This stops the bleed¬ 
ing just as you can check the water fllowing from a hose by press¬ 
ure in any part of its length. It does more than this, however. 
Nature’s method of checking hemorrhage is by the formation of 
a clot, and as pressure prevents the washing away of the blood 
beyond the point of pressure an opportunity is given for a clot 
to form. 

The points where pressure can best be made on arteries in their 


ARTERIAL HEMORRHAGE 75 

course have already been given, but it will be best to say a few 
words more on this subject. 

Bleeding from any part of the scalp may be stopped by a tight 
bandage around the head. . This bandage should encircle the 
head, going across the forehead just above the ears to the back 
of the head behind. 

Bleeding from the side of the head above may also be stopped 
by pressure on the temporal artery in front of the ear just above 
where the lower jaw may be felt working in its socket. 

All arterial bleeding from the head except that already referred 
to and from the neck above had best be checked by pressure on 
the carotid artery. To make such pressure press backward 
with the thumb or fingers deeply into the neck just to the inner 
side of the plainly seen muscle which reaches from the upper part 
of the breast bone to behind the ear. 

Wounds of the neck whether from arteries or veins are so imme¬ 
diately and extremely dangerous, however, that for them direct 
pressure on the bleeding point should be resorted to at once. 

In bleeding from wounds of the shoulder or arm-pit, the sub¬ 
clavian artery may be reached by pressing the thumb deeply into 
the hollow just above and behind the center of the collar bone. 
(Plate XII.) 

In bleeding from any part of the arm or hand, the brachial 
artery is usually pressed outward against the bone just behind 
the inner border of the large muscle of the upper arm. (Plate 
XII.) This artery runs about with the seam of the coat. 

Another method is to put a firm pad of gauze or cloth about the 
size of a small egg at the bend of the elbow, to close the joint 
tight and to bandage in this position. 

For the hand alone, pressure on the pulse at the outer side of 
the wrist and at the same place at the inner side will stop bleed¬ 
ing. Two little pads may be used for this. 

While bleeding in the palm may be checked in these ways, 
direct pressure by means of a stone wrapped in gauze or the like 
firmly bandaged in the palm with the hand closed upon it is 
much better. 

In bleeding from the thigh, leg or foot, press backward with the 


76 


BLEEDING 


thumbs at the middle of the groin where the artery passes over 
the bone. This is four finger breadths below the fold of the 
groin. 

For bleeding below the knee, a pad about the size of a billiard 
ball is placed in the bend of the knee, the joint is bent on it and 
is bandaged in this position just as is done in the elbow-joint. 

In making pressure with the fingers, if you feel the beat of the 
artery, you may be quite sure that with a little care to get it 
between your fingers and the hard point you can check the 
bleeding. If you have stopped the bleeding in the manner just 
described, you may also be quite sure that the patient is safe so 
long as you continue the pressure. 

You will hardly be able to do this for more than ten or fifteen 
minutes, however, as your fingers will become tired and cramped. 
It will be best, therefore, in wounds of the extremities to have 
a tourniquet made to place around the limb against your fingers 
with the pad on the artery; the tourniquet then to be twisted, 
or in proper cases the elbow or knee pads may be used in place 
of the tourniquet. 

One of these methods will usually be all that is necessary if the 
services of a doctor can be procured within two or three hours. 
If this is not the case you will be in a serious position. If either 
apparatus is left in place much longer than this there is consider¬ 
able danger from cutting off the blood-supply that you will 
cause the death of the part below. No part of the body can do 
without blood for a long period. Yet if the pressure is removed 
the bleeding may recommence. Under such circumstances, 
therefore, leave the tourniquet or pad in position as long as you 
dare, say two hours. In the meantime procure an antiseptic 
compress or have one prepared in the manner already described. 
Place this gently on the wound and bandage firmly in place so 
as to make strong pressure on the bleeding point. The pressure 
between the heart and the wound may now be gradually released. 
If the bleeding does not recommence, well and good; if it does, 
the tourniquet or pad must be reapplied. Another attempt to 
remove it should not be made for at least an hour, as time is 
needed for the clot to reform. 


TOURNIQUETS 


77 


Suppose, at first, and this is not wholly improbable, that 
you have failed to stop the bleeding by pressure between the 
heart and the bleeding point—there is still no reason why you 
should become panic stricken. Of course you do not want to 
put your fingers in the wound as this will be very likely to infect 
it, but in case of a severe arterial hemorrhage which you are 
unable to check by pressure between the heart and the bleeding 
point you must at once make pressure on the cut artery in the 
wound. If you have an antiseptic compress or a surgically clean 
cloth to put over your fingers, which are used to make direct 
pressure, so much the better, as this will prevent infection; but 
do not wait to obtain it. When direct pressure is made in this 
way, it should be replaced, if possible, by a compress bandaged 
in place in the manner which has already been described. 

With wounds of the smaller arteries if a compress is firmly 
bandaged on the w'ound at the beginning it will often be all that 
is required to check bleeding. Position is also of value in stop¬ 
ping such hemorrhage. By elevating the arm or leg the heart 
is made to pump against gravity and a much better chance is 
given for a clot to form which will block the injured artery. 

More about Tourniquets. —Tourniquets are instruments used 
to stop bleeding from arteries. Every tourniquet must have a 
strap to go around the limb, a pad to place on the artery and 
some means by which the pad may be made to press on the 
artery and thus to stop the flow of blood. In an improvised 
tourniquet, which is the type most commonly used, the strap 
may be made of a handkerchief, towel, bandage or cravat, and a 
smooth round stone, a cork or some object of similar shape and 
size may be used for the pad. The stone, or the like, had best 
be wrapped in a small piece of cloth so that it will not bruise the 
skin too much. It is then placed over the artery above the 
wound and the strap is best passed twice around the limb and 
tied loosely at its outer side. A stick is introduced between the 
two layers thus formed and is twisted around until the bleeding 
is stopped. If desired, another bandage may be used to loop 
over and to hold the end of the stick from twisting back and so 
relieving the pressure of the pad on the artery. One layer of 


78 


BLEEDING 


bandage may be used for the strap if more is not procurable. 
In order to avoid bruising in using this it is best after introducing 
the stick into the loop to twist away from the body. 

The inner tube of a bicycle tire makes an excellent tourniquet. 
Its end is used for the pad. 

Ready made tourniquets with straps, buckles, and pads may 
be bought. They are more convenient to use. 

Besides the bruising of the muscles and skin which is certain 
to occur to some extent with any tourniquet, there is a much 
graver danger connected with their use. This, as has been 
explained, is due to the fact that in consequence of cutting off 
the circulation, mortification and death of the part may follow. 
Therefore, tourniquets should never be used except when neces¬ 
sary and they should be removed as soon as possible. In doing 
this loosen the* tourniquet and allow it to remain loose if no 
bleeding occurs. It should not be removed as it may be neces¬ 
sary to tighten it again quickly should bleeding recommence. 

Instead of tourniquets, appliances to make pressure on the 
W’hole circumference of a limb and thus to stop bleeding are 
sometimes employed. A special elastic bandage and elastic 
suspenders have been recommended. When possible, however, 
use the tourniquet, as cutting off the whole circulation by pres¬ 
sure on the entire circumference of the limb is much more likely 
to cause mortification than the tourniquet which only exerts hard 
pressure on the artery alone. If circular constriction is used it 
should never be employed for over an hour. 


Venous Hemorrhage 

(Large Veins) 

Treatment. —Stopping bleeding of this character is rather 
simple as compared with checking arterial hemorrhage. Send 
for a doctor. Remove any bands, such as tight collars, belts, 
garters and clothing which prevent the return flow of blood to 
the heart. If a limb be wounded, elevate it so as to assist the 
flow of blood back to the heart. 


INTERNAL HEMORRHAGE 


79 


Apply a compress directly to wound and bandage on tightly. 
If no compress can be obtained which is surgically clean or 
antiseptic, if bleeding is very severe it will be necessary to make 
direct pressure in the wound with the fingers. This will, of 
course, be done at the risk of infecting the wound. If possible, 
keep wounded part in an elevated position for some hours after 
bleeding has stopped. 

With wounds of the neck, such as those caused in an attempt 
to cut the throat, some of the jugular veins are often divided. 
It is quite probable in such a case that death will occur before 
anything can be done. If not, jam the fingers on the bleeding 
point at once and replace them with a compress at your leisure. 
This compress should be bandaged tightly in place. 

Varicose Veins are veins which have become very large from 
weakening of their walls. Only those of the legs need be con¬ 
sidered here. They may burst from injury or without an 
injury, causing serious or even fatal hemorrhage if they are not 
given prompt attention. 

Send for a doctor at once. Put patient on his back. Remove 
all bands around leg above bleeding point. Raise leg. Cut and 
rip clothing so as to get at bleeding point. Turn back clothing 
from wound. 

Place surgically clean or antiseptic compress on bleeding point 
and bandage firmly in position, or when absolutely necessary 
use fingers first for direct pressure on the bleeding point and re¬ 
place them by a clean compress. Keep patient lying down for 
some hours with the leg elevated. 

If there has been considerable loss of blood, cover patient 
warmly and place hot bottles around him. Give stimulants 
only when absolutely necessary to prevent death, as they will 
increase the force of the heart and so the bleeding. 

Internal Hemorrhage 

May result either from a deep wound which cuts a large blood¬ 
vessel of one of the internal organs or from the bursting of a 
blood-vessel of the lungs or stomach. 


8 o 


BLEEDING 


Symptoms. —Those of hemorrhage, but as the bleeding is 
internal it will not be seen. 

Treatment. —Send for a doctor at once. Put patient in a 
lying-down position immediately, with his head lower than his 
body. Apply ice or cloths wrung out in very cold water to the 
point from which you think the bleeding comes. To distinguish 
between bleeding from the lungs and stomach, remember that 
from the former the blood is bright red and frothy and is coughed 
up, while from the latter it is dark and is vomited. Give stimu¬ 
lants only when patient is becoming very weak. 

Nose-bleed 

Usually this does not result from a wound, but comes on 
spontaneously. Slight nose-bleed does not require treatment, 
as no harm will result from it. 

Treatment. Severe. —Place patient in a chair with his head 
hanging backward. Loosen collar and anything tight around 
the the neck. Apply cold to the back of the neck by means 
of a key or of a cloth wrung out in cold water. 

Put a roll of paper under the upper lip between it and the gum. 
If bleeding does not cease, salt and water, a teaspoonful of 
salt or vinegar to a cupful of water, should be snuffed up the nose. 

If bleeding still continues, send for a doctor to come at once. 
Before his arrival place a small piece of cotton or gauze in the 
nostril from which the blood comes and shove it in gently for 
about I inch. A pencil answers very well to push this plug in. 

Pinching the soft part of the nose below the bone will also help 
to stop bleeding. 

Stimulants should be used only as in the other classes of 
hemorrhage. 


QUESTIONS 

1. What is the purpose of the heart? Describe its action. 

2. What is the heart beat and how often does it occur? 

3. What are the different classes of blood-vessels; describe each. 

4. What are the characteristics of bleeding from an artery? 


PRACTICAL EXERCISES 


5. In bleeding from an artery where would you press, and why? 

6. Give the points of pressure for the following arteries: Carotid, 
Temporal, Subclavian, Brachial (2), Femoral, and Popliteal, and ex¬ 
plain from what part of the body pressure on each would stop arterial 
bleeding. Tell exactly what you would do in bleeding from a large 
artery. 

7. What are'the characteristics of bleeding from capillaries? 

8. How would you stop bleeding from capillaries, and why? 

9. What are the characteristics of bleeding from veins? 

10. How would you stop bleeding from veins? 

11. What is the blood? What does it do? 

12. Describe clotting of the blood? 

13. What helps to make the blood clot? 

14. What are the symptoms of great loss of blood? 

15. What is a tourniquet? What are its uses and dangers? 

16. How would you treat bleeding from a varicose vein? 

17. Treatment of internal hemorrhage? 

18. Difference between bleeding from the lungs and stomach? 

19. Treatment of nose bleed? 

PRACTICAL EXERCISES 

1. Show the course of the arteries on the subject and the pressure 
points. 

2. Show how a tourniquet is used. 

3. Have each member of the class show how to stop severe bleeding 
from an artery or a large vein at the same time dressing the wound 
properly. 


6 


CHAPTER VI 


INJURIES DUE TO HEAT AND COLD 

Burns and Scalds; Sunstroke and Heat Exhaustion; 

Frost Bite and Freezing 

BURNS AND SCALDS 

Description. —Burns result from exposure of the body to dry 
heat, such as a fire, while scalds are produced by moist heat in 
the form of hot water, steam, etc. With either, the injury may 
be confined to the skin alone or it may extend deeper. With 
burns all the tissues of the body may be charred down to the 
bone and with scalds all the tissues may be actually cooked. 
With either the danger, which first of all is shock, will depend 
upon the depth, extent and part injured as well as on the age of 
the injured person. 

In children and old people, burns and scalds are particularly 
dangerous. Both burns and scalds of the throat and windpipe 
often cause death, as the swelling of the injured part is likely to 
result in suffocation. 

Causes. —Burns: Flames or fires, hot or molten metal, the 
electric current, explosions of gas or gunpowder, and strong acids 
and alkalies. 

Scalds: Steam, boiling water or hot oil. 

Prevention. —The prevention of burns and scalds is rather a 
complicated subject, as it involves: (i) Prevention of fires. 
(2) Putting out fires. (3) Rescue of persons at fires. (4) 
Extinguishing burning clothing. (5) Avoidance of danger from 
hot or molten metal. (6) Avoidance of electric shock; and 
(7) methods to prevent explosions of gas and gunpowder. 

82 


FIRES 


83 


Prevention of Fires 

Most fires result from carelessness. It would seem as though 
very few people would be foolish enough to take chances in this 
respect but hundreds of fires are caused yearly by lack of common 
sense. Throwing matches in paper baskets is not safe. Hot 
ashes in wooden boxes are a common cause of fires. Clothing 
hung too close to stoves often catches fire as soon as it dries. 
Fireplaces unguarded with screens frequently cause fires from 
burning cinders which snap out on carpets or rugs. Burning 
lamps under shelves are one of the commonest causes of fires. 
Defective wiring results in the loss of many homes. 

Putting Out Fires 

A fire almost anywhere may be easily put out when it starts, 
whereas a very few moments’ delay may result in so big a fire 
that nothing can be done to subdue it until it has burned every¬ 
thing inflammable within reach. It is clear, therefore, that 
everyone should act promptly in case of fire. 

At first a fire may be smothered by a few buckets of water or 
by throwing blankets or woolen clothing upon it. Sand, ashes 
or dirt will all quickly smother a fire. One of these should 
always be used instead of water on burning oil, as water will 
spread the oil and the fire. Anything hanging should, when 
possible, be pulled down before attempting to smother the fire 
in it. A bucket brigade will often prove valuable in putting out 
a fire. This should consist of two lines of men from the nearest 
water supply to the fire. The men in one line pass buckets, 
pitchers or anything else that will hold water from one to another 
till the last man throws the water on the fire. He returns the 
buckets to the water supply by the other line. Remember that 
a draft will fan a fire and therefore keep everything closed as 
much as possible to prevent drafts. 

Rescue of Persons at Fires 

» 

While searching through a burning place it will be best to tie 
a wet handkerchief or cloth over the nose and mouth. Remem- 


84 


INJURIES DUE TO HEAT AND COLD 


ber that the air within 6 inches of the floor is free from smoke, so 
when unable to breathe crawl along the floor with the head low, 
dragging anyone you have rescued behind you. Crawl backward 
in the same way down a staircase or any slope. 

Extinguishing Burning Clothing 

If your own clothing catches on fire when you are alone, do 
not run for help as this will fan the flames and make them burn 
fiercer. 

Lie down on the floor and roll up as tightly as possible in a rug, 
shawl, overcoat, blanket or other woolen cloth, leaving onjy the 
head out. If nothing can be obtained in which to wrap up, lie 
down and roll over slowly, at the same time beat out the fire with 
the hands. If another person’s clothing catches fire, throw him 
to the ground and smother the fire with a coat, blanket, rug or 
the like. 

Avoidance of Danger from Hot or Molten Metal 

Naturally, only persons working about them are subject to 
burns from these sources. Common care and watchfulness will 
do much to prevent them. 

Avoidance of Electric Shock 

Some general rules on this subject are given under the heading 
“Electric Shock.” 

Methods to Prevent Explosions of Gas and Gimpowder 

The mixture of illuminating gas and air in certain proportions 
is a very explosive one. This is also true of the mixture of cer¬ 
tain other gases with air. Any unprotected light will cause an 
explosion, so do not enter a room filled with gas with such a 
light. 

In handling gunpowder it will be best to have no matches in 
the pockets, and lighteditigars, cigarettes, pipes and lights of 
every description are, of course, extremely dangerous. 

S5rmptoms of Burns and Scalds. —Severe burning pain. De- 


BURNS AND SCALDS 


8 S 


pending on depth of injury: Reddening of skin; formation of 
blisters, or destruction of the skin and some of the tissues be¬ 
neath it. Shock, severe except in slight injuries. 

Treatment. —When the skin is simply reddened: 

Exclude air by a thin paste made with water and baking soda, 
starch or flour. Ordinary vaselin or carbolized vaselin, olive 
or castor oil, and fresh lard or cream are all good. One of the 
substances mentioned should be smeared over the burned part 
and on a cloth used to cover it. A light bandage should be put 
on to hold this dressing in place. The services of a doctor will 
hardly be required for such injuries. 

When blisters have formed: 

Treatment may be the same, but if the blistering is very exten¬ 
sive it will be best to show this injury to a doctor. 

Destruction of the skin and some of the tissues beneath it: 

Deep burns require prompt attention from a physician. 
Before his arrival they may be treated by the application of 
the dressing which has been described or like a wound. A 
specially valuable dressing material for such burns, or in fact for 
all burns, is picric acid gauze which is w'et, in steam if possible, 
and is then applied in the form of a compress which should be 
bandaged in place like any other compress. Picric acid may 
increase burning slightly at first but will lessen it later. Be care¬ 
ful not to get it on the clothes as it will not wash out. In burns 
from wax or gutta percha do not try to scrape off. 

Always remember and treat shock. 

Besides the burns which have been described, burns are fre¬ 
quently caused by strong acid and alkalies. The symptoms of 
burns by acids and alkalies are the same as of burns caused by 
heat. With either,' wash off as quickly as possible; best under a 
water tap. 

Acids: While washing injury, have lime-water procured or 
make a mixture of baking soda and water or get soapsuds and 
apply freely. If acid has entered the eye, wash it as quickly as 
possible with water and then with lime-water. Alcohol is what 
should be used in burns from carbolic acid. Pour it freely on 
the burn. 


86 


INJURIES DUE TO HEAT AND COLD 


Alkalies: Wash in same way as with acid burns. Neu¬ 
tralize with vinegar, lemon juice or hard cider. Lime burns 
of the eye should be washed with a weak solution of vinegar 
and water or with olive oil. With both'acid and alkali burns, 
after neutralizing, treat like other burns. In severe burns of 
this character always see a doctor, and when either acid or alkali 
has entered the eye secure the services of a doctor as soon as 
possible. Treat shock. 

The subject of electric shock is treated at length under the 
proper heading. The local effect produced by contact with an 
electric current is a burn. Such burns except those due to a 
flash are deep. It is easy to understand this as contrary to 
what is the case in ordinary burns, which affect the surface first 
and then the deeper structures of the body, an electric burn is 
due to a current of electricity which passes through the body 
burning everything in its course to nearly an equal extent. 

Such burns are very slow in healing but they are not as painful 
as other burns as the nerves are destroyed. The direct current 
causes much severer burns than the alternating. The treat¬ 
ment of electric burns is the same as for other burns. 

Warning. —In all burns, whatever the cause, use care in remov¬ 
ing the clothing. When the clothing sticks to a burn, do not 
drag it off, cut around the part that sticks and soak it off later 
with oil. Never put cotton on a burn as it will stick just as the 
clothing does and it will be almost impossible to remove it later. 

SUNSTROKE AND HEAT EXHAUSTION 
Sunstroke 

This is a condition produced by excessive heat. It is a very 
dangerous one. 

Cause. —Sometimes due to direct exposure to the rays of the 
hot summer sun, especially when the air is moist. 

Most commonly due, however, to somewhat prolonged ex¬ 
posure to excessive heat while working indoors, especially if 
overfatigued. 


HEAT EXHAUSTION 


87 


Too heavy clothing is likely to help to cause sunstroke, and 
hats and caps which do not protect the head from the sun are 
dangerous. 

Drinking any kind of alcoholic liquor before physical exertion 
wdth exposure to the summer sun is very apt to result in sun¬ 
stroke. 

Prevention.—Avoidance of exposure to sun in middle of the 
day in summer. The best possible ventilation of workrooms in 
summer, and avoidance of overfatigue as far as possible. Light 
clothing for summer and light head-gear with space above head 
for ventilation. Avoid alcohol before exposure to sun. 

If one feels the first symptoms of sunstroke he can often pre¬ 
vent actual sunstroke by stopping work, finding a cool place, 
lying down, bathing face, hands and chest in cold water and 
drinking freely of cold water. 

Symptoms.—Usually before actual attack, pain in the head and 
feeling of oppression. Insensibility complete. Face red. Pupils 
dilated. Skin very hot and dry. No perspiration. Breath¬ 
ing labored and sighing. Pulse slow and full. 

Treatment.—Consists in reducing temperature. Send for 
doctor. Remove at once to cool place. Loosen and remove as 
much clothing as possible. 

Apply cold to head and body. To do this, cold water or 
ice should be rubbed over face, neck, chest and in arm-pits. Is 
still better to put patient in a very cold bath or to wrap him in 
sheets wrung out in cold water which should be kept wet and 
cold with water or ice. If this is done, must rub continually to 
prevent shock and to bring hot blood to surface. 

When consciousness returns, may be allowed to drink cold 
water freely. 

Cold may be discontinued when consciousness returns, but 
if skin again becomes very hot, must renew. No stimulants. 

Heat Exhaustion 

Though this condition is caused and prevented in the same 
ways as sunstroke, it is really quite different from it. Heat ex- 


88 


INJURIES DUE TO HEAT AND COLD 


haustion is just what its name states—exhaustion or collapse 
due to excessive heat. 

Symptoms. —Great depression and weakness but not really 
unconscious. Face pale and covered with clammy sweat. 
Breathing shallow. Pulse weak and rapid. 

Treatment. —Send for doctor. Remove to cool place and 
have patient lie down in most comfortable position with clothing 
loosened. No cold externally, but may sip cold water. Stimu¬ 
lants, as tea, coffee, aromatic spirits of ammonia or small 
amount of brandy or whisky with a good deal of water. 

FROST-BITE AND FREEZING 
Frost-bite 

This is due to the local effect of cold on the body, parts of 
which freeze much as do many other objects. The parts of the 
body which are most liable to frost-bite are the nose, ears, toes 
and fingers. 

Cause. —Cold; insufficient clothing; general weakness with 
poor circulation of blood. 

Prevention. —Protection of the body, especially the exposed 
parts named above with sufficient covering when it is necessary 
to expose yourself to intense cold. 

Rubbing of any part of the body which becomes very cold 
in order to increase circulation, or the supply of warm blood to 
the cold part. 

Symptoms. —In intense cold, frost-bite not infrequently occurs 
without one’s knowing it, but usually the ears, fingers, etc., 
become painfully cold and then one suddenly realizes that they 
no longer have any feeling. The color of the frozen part is white 
or grayish-white. 

Treatment. —Object: To gradually bring the frozen part to 
its natural temperature. 

Rub with snow or cold water. Then use warm water 
gradually. 

Warning. —The use of heat at once may result in mortifica¬ 
tion or death of the frozen part. 


FREEZING 


89 


Freezing 

This condition is produced by long exposure to extreme cold. 

Cause. —Extreme cold. Effect of which is increased by over¬ 
exertion, hunger, alcoholic liquors and insufficient clothing. 

Prevention. —If you expect to be exposed to extreme cold, 
procure warm clothing sufficient in amount to protect you from 
its effects. Do not attempt a long journey in the cold without 
food and do not make the journey so long that you are likely 
to have to stop and perhaps lie down on account of exhaustion. 
Do not drink alcoholic liquors, for though they give a tem¬ 
porary sense of warmth, you will be more easily overcome by 
cold after this effect wears off. 

If caught out without shelter in very cold weather use all 
your energy to keep moving. Lying down under such cir¬ 
cumstances almost always results in freezing. 

Symptoms. —Surroundings should be taken into account. 
Depression is so great that appearance of patient is like that of 
a dead man. 

Treatment. —Object is gradually to restore warmth to the 
body. Take patient into a cold room, rub limbs toward body 
with rough cloths wet in cool water; increase temperature of 
room if possible. This should be done gradually and cloths 
should be wet in warmer and warmer water. As soon as patient 
can swallow, give stimulant—coffee or tea in small quantities, 
frequently repeated with the addition of a little whisky, brandy, 
or aromatic spirits of ammonia. 

Patient should not be placed before an open fire or in a hot 
bath until circulation has become active in cool room. You 
will know this by an increased force of the pulse, better breath¬ 
ing and more warmth and color in the skin. 

QUESTIONS 

1. What is a burn? 

2. What is a scald? 

3. Why are burns of the throat and windpipe specially dangerous? 

4. What are the general principles governing the prevention of fires? 
Suppose a fire occurs, how would you try to put it out? 


90 


INJURIES DUE TO HEAT AND COLD 


5. How would you rescue a person in case of fire? 

6. How would you put out burning clothing? 

7. What are the symptoms of burns and scalds? 

8. Treatment: Very shght burns and scalds; where blisters have 
formed; very deep. 

9. What is the treatment of burns from strong acids and alkalies? 

10. What can you say of burns from electricity? 

11. What is the difference between sunstroke and heat exhaustion? 
Treatment of each? 

12. What is frost-bite? What are the symptoms of frost-bite? 

13. How would you treat frost-bite? 

14. How would you treat freezing? 

PRACTICAL EXERCISES 

Treatment of all classes of wounds and burns, with methods of 
checking bleeding by the class. 


CHAPTER VII 


SUFFOCATION AND ARTIFICIAL RESPIRATION: 
DROWNING; ELECTRIC SHOCK; GAS 
POISONING; HANGING 

Suffocation is caused in different ways, but whatever the more 
remote cause, the immediate cause is always interference with 
the supply of good air to the lungs, and with the escape of bad 
air from the lungs. 

Some knowledge of the Respiratory System is necessary iri 
order that the subjects of this chapter may be understood. 

The Respiratory System 

This system consists of the Nose and Mouth, the Windpipe 
and the Lungs. 

At the upper end of the windpipe is the Larynx, part of which 
we know as the prominent Adam’s Apple in the throat. As the 
larynx is in front and the gullet is behind, food and water passing 
to the latter must pass over the upper end of the larynx and would 
enter it if some protection were not provided. This is afforded 
by the Epiglottis, a muscular flap or curtain which falls into 
position, covering the upper end of the larynx so that ordinarily 
food does not enter it. Sometimes, however, the epiglottis does 
not do this, especially if one swallows quickly or attempts to 
talk while swallowing. In this case choking results from food 
entering the larynx, or, in common words, one has swallowed 
the wrong way. The attempt to give food or water to an un¬ 
conscious person will also result in choking him because his 
epiglottis does not close. 

The Lungs are two soft, spongy structures, each of which is 
bag-like in shape and is made up of air cells with many blood- 

9x 


92 


SUFFOCATION AND ARTIFICIAL RESPIRATION 


vessels surrounding them; they are sometimes compared to a 
bunch of grapes. The lungs are hermetically sealed in the chest, 
so that when the cavity of the chest is increased or diminished 
in size, the same effect is produced on the lungs themselves. 
Certain muscles are of great importance in filling and emptying 
the chest and lungs. Ordinarily, the muscular movement con¬ 
sists simply of the bellows action of the chest and the up and 
down movement of the diaphragm. In order that the chest 
may be enlarged to its greatest capacity, however, some of the 
muscles of the upper extremity must also take part. In order 
that they may do so, the arms are raised vertically above the 
head, so that certain muscles attached to the chest wall and to 
the upper extremities will, when the latter are fixed, raise the 
ribs and thus enlarge the chest. The chest, too, is elastic and 
direct pressure upon it will diminish its size and so force the air 
from the lungs. 

The rate of respiration is i6 per minute. 

The lungs aerate or oxygenate the blood. The small blood¬ 
vessels surrounding the air cells which the pure air breathed in 
finally reaches, carry dark blood which has lost its oxygen in the 
body. This blood receives oxygen from the pure air and returns 
to the heart as bright arterial blood. The air which is expelled 
from the lungs has not only lost its oxygen to the blood, but has 
also received certain impurities from it. 

From what has been said it is easy to understand that the nose 
and mouth and the windpipe are simply a passageway for the 
air going to and coming from the lungs. Naturally, anything 
which blocks this air in its course will interfere with the supply 
of air to the lungs and complete blockage will result in early 
death from suffocation or asphyxiation. 

A special nerve center in the brain governs breathing just as 
other similar nerve centers govern other actions of the body. 
Paralysis of this center will stop the breathing as effectively and 
completely as blocking the passage of the air to the lungs. 
Water and some gases, such as illuminating gas, will also prevent 
good air entering the lungs and will thus cause suffocation. 

Symptoms of Suffocation. —At first the lips, the face, the 


ARTIFICIAL RESPIRATION 


93 


tongue and the nails get blue while at the same time the suffo¬ 
cated person gasps and struggles for breath. The eyes are 
staring and show suffering. Later the struggle for air becomes 
greater with all the symptoms mentioned intensified. Regular 
convulsions come on in the fight to get good air. The last stage 
and, of course, this is often the only one seen, is complete 
unconsciousness, with stoppage of the breathing or an occa¬ 
sional gasping breath. The lips, face, tongue, nails, and in 
fact the skin of the whole body are blue. 

Artificial Respiration 

A suffocated person cannot get the good air into his own 
lungs and the bad air out but fortunately we can do this for 
him by certain movements imitating breathing. This is called 
artificial respiration. Before beginning it loosen all clothing so 
it does not bind the body anywhere. Keep everybody away; a 
suffocated person needs all the good air he can get. 

Artificial respiration consists of alternate movements which 
diminish the size of the elastic chest, and then by relieving pres¬ 
sure permit it to regain its original size. 

In some forms of artificial respiration the size of the chest is 
also increased by movements which put on the stretch the 
muscles from the arms to the chest. 

The Schaefer or Prone Pressure Method of artificial respiration 
is now generally used, though the older Sylvester Method is still 
very popular. The advantages of the Schaefer Method are that 
by it a greater amount of air is gotten into the lungs, it is not 
necessary to hold the tongue out and it is much easier for the 
operator. Unless the operator is extremely rough no danger 
attends its practice. Of course, if either of the arms is broken, 
the Sylvester Method should never be employed. 

In the Schaefer Method the patient is laid on the ground face 
down. The arms may be stretched out at full length over his 
head or one arm may be bent so the forehead rests upon it. In 
either case the face must be placed slightly to one side so that 
the ground will not block off the air from nose and mouth. 

As soon as the patient is in proper position, the operator 


94 


SUFFOCATION AND ARTIFICIAL RESPIRATION 


kneels at one side, or astride his body but without resting his 
weight upon it. The palms of his hands are placed on the short 
ribs across the small of the back with the thumbs nearly together. 
The operator by letting his weight fall on his wrists by bending 
his body forward decreases the size of the chest and the air is 
expelled from the lungs. The pressure is then released by the 
operator swinging backward, the elastic chest springs out to its 
original size and the air is drawn into the lungs. The movement 
is at the rate of 12 to 14 a minute. Better time with a watch. 

The Sylvester Method.—Put on the back. The tongue must 
be held out as otherwise it will fall back and block the wind¬ 
pipe. Grasp it in a dry cloth or pinchers. Have some one hold 
it out or better hold it out by a bandage or rubber band over the 
tongue and under the jaw. Put a rolled up coat, a small log or 
something else of the same shape and size under the suffocated 
man’s shoulders. This will straighten his windpipe. Kneel 
just above patient’s head, catch both his arms just below the 
elbows. Draw the arms outward and upward gently and steadily 
and hold them as far as they will go above head for about two 
seconds. This motion opens and expands the chest to the great¬ 
est possible extent. This is due to the fact that certain muscles 
are attached to both arms and ribs and when the arms are raised 
these muscles raise the ribs and so enlarge the chest. Then 
bring the arms down till the elbows press against the chest; a 
little pressure will diminish the size of the elastic chest as much as 
possible. Do this for about two seconds. Continue these 
motions about fifteen times per minute. This when done prop¬ 
erly is hard work for the operator and he should be relieved by 
some one else as soon as he grows tired. 

Whatever the method of artificial respiration used it should 
be kept up for at least an hour and a half. 

The further treatment is as follows: 

Ammonia, on a sponge or handkerchief put under, but not on, 
the patient’s nose will help to revive him. 

At the same time that one or two persons are performing 
artificial respiration, without interfering with them, others 
should cover the patient with a dry coat or blankets. 


DROWNING 


95 


As soon as the patient begins to breathe himself, but not be¬ 
fore, his limbs should be well rubbed toward the heart under the 
blankets. This will help to restore the circulation. 

When the patient is partially restored he may have a chill 
and vomit. If he vomits while on his back he must be turned 
on his side so that the vomited matter will not enter the windpipe. 

He should afterward be put to bed well covered and sur¬ 
rounded with hot bottles. The windows should be opened so 
that he may have plenty of air. 

After the danger is over the patient should be allowed to sleep 
quietly. 

He will feel very nervous and shaken for a time and should be 
given absolute rest till he recovers from this condition. No 
food except hot beef tea should be given for several hours. 
Hot coffee, however, is useful as soon as the patient can swallow 
and retain it. 

A doctor is always required for suffocation. 

While the pulmotor is now often used to advantage in place 
of artificial respiration, you must never wait for it. 

Warning. —If the breathing stops at any time after it has 
once begun you must immediately start again with artificial 
respiration. Piece in rather than do it all. Let the patient 
breathe himself as he can. You are to make the necessary 
movements when he cannot. Maintain same rate. 

The commoner causes of suffocation will now be discussed in 
more detail. Of course the important treatment for all of them 
is artificial respiration. 


Drowning 

Prevention. —This will be spoken of under two heads: i- 
Prevention of accidents that may result in drowning. 2. Rescue 
of drowning persons. 

I. Prevention of Accidents that may Result in Drowning.— 

Boating accidents are frequent in all parts of the country during 
the summer season. In order to do your part to prevent them— 
Remember: A light boat is not intended for heavy seas; do not 


g6 


SUFFOCATION AND ARTIFICIAL RESPIRATION 


RESCUE METHODS 


Rescuer should not go into the water unless Necessary but should use a Line, Buoy or Boat 



4. Fourth Method 



6. Ice Rescue 


Plate XIV.—Drowning 























































































































































































































RESCUE OF DROWNING PERSONS 


97 


change seats except in a wide and steady boat, and above all 
things do not put yourself in the class of idiots who rock the boat. 
In case you are thrown into deep water by the turning over of a 
boat, or from any cause, do not lose your presence of mind even 
if you cannot swim. Remember that the water will almost 
support your weight. Allow yourself to sink low so your nose 
is just above the water and support yourself by a hand on the 
boat. Even an oar under the chin will hold you up. If there 
is nothing which will help to support you, lie flat on the back 
with the arms stretched out. Especially in salt water with 
light clothing, one may float almost indefinitely in this position. 
To do so it is necessary to keep cool if the water or spray rises 
over the face momentarily. Throwing up the head, or still 
worse the arms or legs to prevent this will result in sinking. 

At the seashore, unless you are a strong swimmer, do not go 
outside the life-lines and if the undertow is strong be careful that 
you do not walk out so far that you may be carried off your feet. 

The art of swimming should be made a part of the education 
of every boy and girl. It is not enough to know how to swim a 
few strokes. One should at least be able to swim for a few 
moments while dressed. 

Very cold water and very long swims are likely to result in the 
exhaustion of even a strong swimmer and are therefore hazardous 
unless a boat accompanies the swimmer. 

2. Rescue of Drowning Persons. —If possible, do not attempt 
to rescue a drowning person in deep water by entering the water 
yourself. The best interests of the drowning person are served, 
when practical, by holding out or throwing something into the 
water on which he can support himself till he can be pulled ashore 
or reached in a boat. In case a person has fallen into deep 
water near the shore take an oar, a pole, a rope or even your 
coat and hold it out so the drowning person may grasp it. Life 
preservers, boxes, boards or logs may also be thrown into the water 
close to the person drowning. As has been stated above, a 
small, floating object is quite sufficient to sustain a person’s 
weight in the water. 

If the person in danger of drowning is so far from the shore 
7 


98 


SUFFOCATION AND ARTIFICIAL RESPIRATION 


BREAKING DEATH GRIPS 



1. When Rescuer is Held by Wrists _ 



2. When Rescuer is Clinched around the Neck 
RESTORING NEARLY DROWNED 



1. Artificial Respiration (A) 


3. When Rescuer is Clutched around 
the Body or Arms 



2. Artificial Respiration (B) 


Plate X V.—Drowning 



















































































































































































































































RESCUE OF DROWNING PERSONS 


99 


that the methods just spoken of cannot be used you must enter 
the water to rescue him. Take off as much of your clothing as 
possible. It is especially necessary to rid yourself of your shoes. 
If you are not a strong swimmer it will be much better to support 
yourself with a life preserver, a board, box, or the like, when 
swimming out to the drowning person. 

Always take care not to allow a drowning person to grasp you 
for this will very likely result in the loss of both your lives. If 
he succeeds in seizing you it will be safest to allow yourself to 
sink or to strike him a blow in the face in order to make him 
loosen his hold. There is no cruelty in such a blow; it may be 
his only salvation. Unconscious persons are in fact rescued 
much more easily. 

The methods of breaking death grips are illustrated and should 
be adopted in proper cases. 

Always approach a drowning man from behind. A practical 
method of rescue is to grasp his hair or collar with your left 
hand and his right shoulder with your right hand keeping him 
at arm’s length with his mouth and nose just above the water, 
then “tread water.” As soon as you can, seize his right wrist 
and pull it behind his head, then take a few strokes to get on 
your back, at the same time pull the person you are rescuing on 
your chest and start to swim backward to shore. Swim as low 
as possible, with your face and that of the drowning person 
just out of the water. 

To rescue a person who has broken through the ice: You 
should first tie a rope around your body and have the other end 
tied, or held, on shore. Then secure a long board, or a ladder, 
crawl out on this or push it out so that the person in the water 
may reach it. If nothing can be found on which you can support 
your weight do not attempt to walk out toward the person to 
be rescued, but lie down flat on your face and crawl out as by 
doing this much less weight bears at any one point on the ice 
than in walking. 

Symptoms. —Are of course those of suffocation. In addi¬ 
tion a frothy fluid is often noticed in the mouth and nose and the 
body is cold. 


lOO 


SUFFOCATION AND ARTIFICIAL RESPIRATION 


Treatment.—Artificial respiration and other measures just 
as described under Artificial Respiration. If there is mud 
or water in the mouth, first clean it out by a handkerchief 
wrapped around the first finger. If the Schaefer Method is 
used, you may proceed with artificial respiration at once. If 
the Sylvester is employed, before giving it, it will be well after 
cleaning what mud and water you can from the mouth to turn 
the patient on his face, clasp hands around his waist, raise him 
by the middle and hold up for a few seconds in order that water 
may drain from throat and lungs. Don’t waste time before 
beginning artificial respiration. 

Electric Shock 

The more general use of electricity is making accidents due to 
it more common year by year. Ev^n now the third rail and the 
live wire are responsible for many injuries and deaths. 

The ordinary trolley wire carries a current of about 500 volts, 
and incandescent and arc-light currents run from 2500 to 3000 
volts. The passage of these powerful currents through the body 
causes dangerous shock or even death. 

Prevention.—The third rail is always dangerous, so avoid it. 

Swinging wires of any kind may somewhere in their course 
be in contact with live wires, so they should not be touched. 

Electric wires must always be carefully avoided. 

S5rmptoms.—Are due to paralysis of the nerve center in the 
brain which governs breathing and in consequence are those of 
suffocation. 

Sudden loss of consciousness occurs when a powerful electric 
current passes through the body. 

The breathing may be entirely stopped or it may be shallow 
and only occasional. 

Weak pulse as the electric current affects the heart as well as 
the breathing apparatus. 

If hands are in contact with a live wire, may not be able to 
release them at first. 

Burns of hands or other parts of the body in contact. 


ELECTRIC SHOCK 


lOI 


The direct current causes severe burns but is not so dangerous 
to life. The alternating while more dangerous to life does not 
cause as severe burns. Low-voltage currents, especially alter¬ 
nating currents, cause many deaths. 

Little difficulty should be experienced in making out cause of 
injury. 

Treatment. —First, rescue; second, treat. 

I. Rescue. —In some cases it will be possible to shut off cur¬ 
rent and this should always be done if it can be done quickly. 

A person in contact with wire or rail carrying an electric 
current will transfer current to rescuer if the latter puts him¬ 
self in the line of passage of current. Therefore, he must not 
touch the body of a person touching a live wire or a third rail 
unless his own body is thoroughly insulated. Naturally too, 
he must not himself, in attempting to aid the injured person, 
bring any part of his own body in contact with the live wire 
or other apparatus carrying the electric current. Moreover, 
he must act very promptly for the danger to the patient is 
much increased the longer the electric current is permitted to 
pass through his body. If possible, the rescuer should insulate 
himself by covering his hands with a rubber coat, rubber 
sheeting, or even several thicknesses of dry cloth. Silk is a 
good non-conductor. In addition he should, if possible, com¬ 
plete his insulation by standing on a dry board or a thick piece 
of dry paper, or even on a dry coat. Rubber gloves and shoes 
or boots are still safer, but they cannot usually be procured 
quickly. If a live wire is under a patient and the ground is 
dry it will be perfectly safe to stand upon it and to pull him 
off the wire with the bare hands. But they should touch only 
his clothing and this must not be wet. 

A live wire lying on a patient may with safety be flipped off 
with a dry board or stick. 

In removing the live wire from the patient, or the patient from 
the wire, do this with one motion as rocking him to and fro on 
the wire will increase shock and burn. 

A live wire may be safely cut by an axe or hatchet with a dry 
wooden handle and the electric current may be short-circuited 


102 


SUPrOCATION AND ARTIFICIAL RESPIRATION 


HOW TO RESCUE PERSON FROM CONTACT WITH ELECTRIC CURRENT 
(When possible the rescuers should Stand on Dry Wood or Cloth) 




1. With Folded Newspaper 



1 - 

\i\\ 




>• " 



2. With Coat or Sweater 



5. With Garment or Cloth 


Plate XVI.—Electric shock. 



































GAS POISONING 


103 


by dropping a crowbar or poker on the wire. These should 
be dropped on the side from which the current is coming and 
not on the further side as the latter will not short-circuit the 
current before it has passed through the patient’s body. Drop 
the metal bar, do not place it on the wire or you will then be 
made a part of the short circuit and receive the current of elec¬ 
tricity through your body. 

2. How to Treat. —Some cases of electric shock from powerful 
currents are hopeless from the beginning. It is impossible to 
tell this at first, however, and, therefore, an attempt should 
always be made to save the life of patient by prompt treatment. 
The treatment is artificial respiration. 

It is possible for those who have received an electric shock 
which does not render them unconscious to perform artificial re¬ 
spiration of a sort on themselyes and so to recover without further 
treatment. This is done by raising the upper extremities and 
lowering them again and again while taking deep breaths. 

Burns from electricity should be treated like other burns. 

Gas Poisoning 

Illuminating gas is so generally employed that this form of 
suffocation is common. Very similar effects are produced by 
other poisonous gases. 

Causes. —The common gases which produce suffocation are 
illuminating gas, coal gas from furnaces or stoves and smoke 
often mixed with different gases. Poisoning from ammonia 
fumes is seen now much more frequently than formerly, as at 
present ammonia is so largely used in refrigerating and ice¬ 
making machinery. 

Prevention. —Naturally is dependent on the cause. Extra¬ 
ordinary care must be taken wherever much gas is mixed with 
the air. 

Leaks in gas pipes should be promptly repaired. Be careful 
in turning off gas to make sure that gas is actually shut off. 

It is dangerous to leave a gas jet burning faintly when you go 
to sleep, as it may go out if pressure in gas main becomes less, 


104 


SUFFOCATION AND ARTIFICIAL RESPIRATION 



Plate XVII.—Electric Shock. 
















GAS POISONING 


105 


and if pressure is afterward increased, gas may escape into 
room in large amount. 

Coal gas will escape through red-hot cast iron, and very big 
fires in such stoves are dangerous, especially in sleeping rooms. 

Charcoal burned in open vessels in tight rooms is especially 
dangerous. 

In sewers and wells it is customary to lower a lighted candle or 
torch; if this does not burn it is certain the air is so impure that 
one cannot live in it. 

Symptoms. —Are those of Suffocation but in those slightly 
affected are not so severe: Headache, dizziness, sick at stomach 
and vomiting, very sleepy, weak, rapid breathing, fast pulse. 

Treatment. —Rescue person overcome promptly and take 
him where there is plenty of good air. To rescue an uncon¬ 
scious person in a place filled with gas, move quickly and carry 
him out without breathing yourself. Take a few deep breaths 
before entering and if possible hold breath while in the place. 
Frequently less gas will be found near floor. So, one may be 
able to crawl where it would be dangerous to walk. The treat¬ 
ment is artificial respiration. 

In those slightly affected, artificial respiration is unnecessary. 
Aromatic spirits of ammonia, one-half teaspoonful in half glass of 
water. Repeat if necessary four times at 15-minute intervals. 
Smelling salts to nose. Baking soda, a teaspoonful in one-half a 
glass of water will settle the stomach and cause belching of gas. 
In gas works, effervescing phosphate of soda is often provided and 
is perhaps the best remedy instead of baking soda though if it is 
not at hand it would be a bad mistake to wait to procure it in¬ 
stead of using baking soda. The dose of phosphate of soda is 
two teaspoonfuls in one-half glass of water. In gas works too, 
weiss beer or plain soda water are sometimes used instead of phos¬ 
phate of soda. The value of breathing in vinegar from a sponge 
and of the current of air from an electric fan is also generally 
recognized. 

If a person with gas poisoning in this stage is fairly strong he 
should be walked around, two persons supporting him with his 
arms around their necks. If feet drag this shows he is too weak 


Io6 SUFFOCATION AND ARTIFICIAL RESPIRATION 

for this treatment and he should be placed lying down. Then 
if he is not breathing well, start artificial respiration. 

Even in mild cases it is much safer to send for a doctor. 

Hanging 

Hanging is a common means of suicide. As the rope cuts off 
the air to and from the lungs the result is, of course, suffocation. 

Treatment. —Cut down and remove the rope from the neck. 
Artificial respiration. 


QUESTIONS 

1. What is the cause of suffocation? 

2. Of what does the respiratory system consist? 

3. How may the supply of air to the lungs be interfered with? 

4. Symptoms of suffocation? 

5. What is Artificial Respiration? 

6. What should you do for a suffocated person besides performing 
the movements of artificial respiration? 

7. Drowning. Prevention? Rescue? Treatment? 

8. How weak a current will cause dangerous electric shock? 

9. Electric shock; prevention; symptoms? 

10. What would you do to rescue a person in contact with a live wire? 

11. How would you treat him after he had been rescued? 

12. How would you treat a burn due to electricity? 

13. Gas Poisoning. Prevention? Treatment? 

14. What would you do for a person who had attempted suicide by 
hanging? 


PRACTICAL EXERCISES 

Each member of the class should be required to give artificial 
respiration by the Schaefer and Sylvester Methods. 


CHAPTER VIII 


UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 

UNCONSCIOUSNESS 

Unconsciousness, is lack of consciousness. One who is un¬ 
conscious knows nothing of his surroundings, or of what is 
happening. There are, however, different degrees in this con¬ 
dition. That is to say, the same causes when not exerted to 
so great an extent may only cause partial unconsciousness, which 
may be recovered from without going further, or may be 
followed by total unconsciousness. Insensibility and uncon¬ 
sciousness are two different names for the same thing. Per¬ 
haps no condition which the first-aid student may be called 
upon to treat may prove more puzzling than this. Unconscious¬ 
ness may result from a number of different causes, and in order to 
give the best treatment one should determine first what the 
cause is. Always make an earnest effort to do this by taking 
the surroundings into account as well as by examination of the 
patient. 

Suppose, however, that you are unable to determine the cause 
of unconsciousness. At least make very sure that it is due 
neither to a poison, to bleeding nor to sunstroke, for each of 
these demands immediate special treatment, or to suffocation 
for which you would, of course, give artificial respiration. 
Then, unless it is necessary to give the special treatment, if 
the patient is pale and weak have him lie down with his head 
low and warm and stimulate him in every possible way; on the 
contrary, if the face is red and pulse is very strong, while the 
position for the patient should also be lying down, the head 
should be raised. No stimulants should be given in the 
latter condition and cold water should be sprinkled on face 
and chest. 

107 


Io8 UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 

A doctor is always needed. 

The common causes of unconsciousness are: Bleeding, shock, 
electric shock, sunstroke, heat exhaustion, freezing, fainting, 
fits, apoplexy and injury to the brain, and certain poisons. 

The six causes which head this list have already been dis¬ 
cussed at length and are only mentioned here so that the first- 
aid student may find in one place all the commonest causes 
of unconsciousness. Likewise and for the same practical reason, 
poisoning by alcohol, opium and its preparations, and carbolic 
acid are discussed here. 

1. Bleeding. —Ordinarily you will see the blood in a wound. 
Even in internal bleeding from the lungs or stomach, blood is 
often coughed up or vomited as the case may be. 

2. Shock. —You learn an injury has been received, or there 
is other evidence of injury. 

3. Electric Shock. —Should be no difficulty in finding out the 
cause. 

4 and 5. Sunstroke and Heat Exhaustion. —In very hot 
weather. In sunstroke the patient is so hot that his skin seems 
to be burning. With heat exhaustion, the skin is cold and 
clammy like in a faint which it resembles closely. 

6. Freezing. —Should experience no difficulty. 

7. Fainting 

Cause. —A lack of blood to the brain. Some persons often 
faint. Fainting is common in any form of weakness, as when 
recovering from a severe illness. Some people faint at the sight 
of blood. 

Prevention. —A person who has not yet recovered his full 
strength after an illness or injury should be careful not to overdo 
physically. Persons who faint from trivial causes require the 
advice and treatment of a physician. Remember that fainting 
may be due to a hemorrhage, and if there is any reason to suspect 
that the patient is bleeding, examine him carefully and check 
the bleeding promptly. 

S5rmptonis. —Usually occurs in overheated, crowded places. 


FITS 


109 

Patient becomes paler and paler and finally sinks to the floor 
unconscious. Unconsciousness is partial or complete. Face is 
pale, frequently covered with cold perspiration. Pupils are 
natural. Breathing is shallow and sighing. Pulse is weak and 
rapid. No other cause for unconsciousness. 

Treatment. —Sometimes can prevent fainting by having 
person who feels faint double over so that head is between knees. 
If this does not prove effective at once do not continue. Air, 
especially cold air, and cold water often prevent actual fainting 
when a person feels faint. If patient has actually fainted, put 
him in lying-down position with his head lower than the rest of 
his body, so that brain will receive more blood. Loosen clothing, 
especially around neck, for same purpose. Open windows, if 
necessary, and keep away crowd so that patient may get plenty 
of air. Sprinkle face and chest with cold water. Smelling 
salts or ammonia to nose. Rub limbs toward body. Do not 
allow patient to get up until fully recovered. May give stimu¬ 
lant when patient has so far recovered that he is able to swallow. 

8. Fits 

These, which usually occur in young adults, begin gen¬ 
erally by the afflicted person falling to the ground, perhaps 
with a cry, and then going through all sorts of convulsive move¬ 
ments, throwing the arms and legs about, jerking the head, 
rolling the eyes, and foaming at the mouth, and perhaps biting 
the tongue. There should be little difficulty in telling what is 
the matter at this stage, but afterward, unconsciousness 
comes on. 

If you can see or find out about the convulsion you will at 
once know what the trouble is. In the unconscious stage this 
is not so easy. Disarranged clothing, foam at the mouth, and 
the bitten tongue should be looked for. 

In the unconscious stage, it is only necessary to allow the 
patient to rest quietly. Do not try to prevent the convulsions 
by holding him. Put him on the ground, or floor, or somewhere 
else where he cannot injure himself by threshing about and put 


no UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 

a piece of wood covered with a handkerchief in his mouth so 
that he cannot bite his tongue. 

9. Apoplexy and Injury to the Brain. 

Apoplexy is due to the bursting of a diseased blood-vessel in 
the brain. The escaping blood presses on the nerve-centers 
and this causes the symptoms. An injury of the brain also in¬ 
jures these centers, so from a first-aid standpoint the symptoms 
and treatment of apoplexy and brain injuries may be considered 
together. 

Symptoms. —Apoplexy often comes on suddenly. In brain 
injury, may see and learn of injury to head. In brain injury 
there may be hemorrhages from nose, ears, mouth and eyes. 
Unconsciousness, complete. Face: Red in apoplexy; pale 
in injury. Pupils, large and frequently unequal in size. Eye¬ 
balls insensitive to touch. Breathing, snoring. Pulse: full 
and unusually slow. Paralysis usually on one side of body. 
Test by raising arm or leg. If paralyzed, will drop absolutely 
helpless. 

Treatment. —Send for doctor at once. Rest and quiet, in a 
dark room if possible. In lying-down position with head and 
shoulders raised on a pillow. Ice or cold cloths to head. Hot 
bottles to limbs. No stimulants. 

10. Alcoholic Poisoning 

Alcoholic poisoning or intoxication represents the final stage in 
acute drunkenness; that is, the common spere. 

Symptoms. —Perhaps evidence of intoxication. Unconscious¬ 
ness, partial or complete; frequently able to arouse patient to 
some extent. Face sometimes flushed and bloated, or may be 
pale. Skin cool and may be moist. Pupils natural or large. 
Eyeballs red, but not insensitive to touch. Breathing about as 
usual when in deep sleep. Pulse, usually rapid and weak, but 
may be slow. May be strong odor of liquor. No paralysis. 

Warning. —Insensibility from alcohol and apoplexy are more 
often mistaken one for the other than are any other forms of 
unconsciousness. The most important symptoms in which 


POISONING BY OPIUM 


III 


they differ are the state of the pupils, the sensitiveness of the 
eyeballs and paralysis. The odor of liquor on the breath is 
of little value, because a person with apoplexy may have been 
drinking. 

Treatment. —If any doubt whether drunkenness or apoplexy, 
always treat for apoplexy and be particularly careful not to make 
patient vomit, as this will cause more bleeding into brain. 

In drunkenness, if able to arouse sufficiently, give emetic— 
mustard and water or luke-warm water are usually easily pro¬ 
cured. Afterwards strong coffee or aromatic spirits of ammonia. 
Hot bottles around patient. Rub limbs toward body to increase 
circulation. 

II. Poisoning by Opium or some Preparation of Opium, 
usually Morphine 

Cause. —These poisons are often taken in attempts at suicide 
but a good many soothing syrups and quieting mixtures contain 
opium or one of its numerous preparations and as children are 
very susceptible to these drugs cases of poisoning due to them are 
not uncommon. 

Prevention. —As with all poisons, no opium mixture should 
be allowed to fall into the hands of g,nyone who will not know 
what it is and its dangers. Soothing syrups should never be 
given to children. All drugs containing opium are dangerous 
unless prescribed by a doctor. 

Symptoms. —May find person has taken opium or may find 
bottle which contained poison. Unconsciousness which comes 
on gradually and finally becomes complete. Face red at first, 
finally dark purple. Lips bluish. Pupils very small, like pin 
heads. Breathing full and slow at first, gradually slower and 
shallow. Pulse, slow and full, afterwards weak. Possibly smell 
of laudanum on breath. Symptoms that should be especially 
noted are pin-head pupils, breathing and that patient is first 
very sleepy and then becomes unconscious. 

Treatment. —Give an emetic: mustard and water; salt and 
water; luke-warm water alone in large quantities. Exact 
dose is unimportant, give in large quantities and repeat if pro- 


112 UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 

fuse vomiting does not occur. (May have difficulty in getting 
emetic to work.) Plenty of strong coffee. Try to arouse patient 
by speaking loudly and threatening him, also slap with wet 
towel. Walk up and down, two persons supporting him. Must 
stop this if patient is weak or you will exhaust him. Then put 
on back. Artificial respiration will then be required more than 
anything else. Stimulants. 

12. Carbolic-acid Poisoning 

Cause. —This poison is easily obtained and is often used in 
attempts at suicide. On account of its strong odor it is rarely 
taken accidentally. 

Prevention. —^Like that of other poisons. As it produces bad 
burns it should never be applied to the skin. 

Symptoms. —You may find poison has been taken or the bottle 
which contained poison. Vomiting and great pain. Skin 
covered with cold sweat. If severe case, unconsciousness, 
usually followed promptly by death. Strong carbolic acid is a 
very rapid poison. May almost always know by the strong 
smell of carbolic acid. Lips, tongue and mouth are burned 
white by pure, and black by impure carbolic acid. 

Treatment. —Rinse mouth with pure alcohol. If grown per¬ 
son, should swallow three or four tablespoonfuls of alcohol 
mixed with an equal quantity of water. (Use other remedies 
for children.) Follow this in five minutes with two tablespoon¬ 
fuls of Epsom salts dissolved in a little water. Though not so 
good, lime-water may be used to rinse mouth, several glasses 
of it being also swallowed. Three or four raw eggs may be given, 
or castor or sweet oil. Stimulants always, and keep warm. 

In burns of the skin from carbolic acid, use alcohol to neutral¬ 
ize the acid. Afterwards freat like other burns. 

POISONING 

Alcohol, opium, and its preparations, and carbolic acid have 
already been discussed. 


POISONING 


II3 

Any substance taken into the body which will cause death is a 
poison. But only poisons which are swallowed will be con¬ 
sidered here. 

Prevention. —Accidental poisoning may be prevented to a 
very great extent by never taking any medicine which is not 
properly labeled, and by putting poisons, when they must be 
kept on hand, in a safe place under lock and key. 

Symptoms and Evidence of Poisoning. —The symptoms vary 
with the special poison. But there is certain evidence which 
indicates, in the majority of cases, that a poison has been taken. 
Sudden, severe and unexpected illness in any one after eating, 
drinking or taking medicine may be due to poison. 

Possibly the poisoned person has been melancholy and has 
talked of suicide. Bottles, glasses or the like in which some of 
the poison remains may be nearby. 

Frequently a person who has taken poison intentionally, 
becomes frightened and is only too glad to tell some one that he 
has poisoned himself and what poison he has used. In accidental 
poisoning the patient is, of course, willing to tell all he knows 
in reference to the poison. 

If a number of persons who have eaten the same food become 
seriously ill after a meal, it is almost certain they are suffer¬ 
ing from poison, probably decayed food or the so-called pto¬ 
maine poisoning. 

Treatment. —Delay is likely to prove fatal in poisoning so 
whatever is done must be done promptly. Always send for a 
doctor at once but do not wait for his arrival. An emetic is not 
the best treatment for every poison. But, nevertheless, it should 
always be given if you do not know what poison has been taken 
and the proper antidote. 

Running the finger down the throat or drinking a large quan¬ 
tity of warm water will usually cause vomiting. 

Good emetics are: 

Mustard and water or salt and water, a teaspoonful of either 
in a glass of luke-warm water. One or two teaspoonfuls of the 
wine or syrup of ipecac are also good and usually easily pro¬ 
cured. Do not waste time in getting the exact dose, however, 
8 


114 UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 

and repeat if profuse vomiting does not result. Drink luke-warm 
water between attacks of vomiting. 

The following table, giving the antidotes for special poisons 
may be consulted with benefit if it is at hand. No attempt 
should ordinarily be made by the first-aid student to learn it by 
heart. 

Poisons are of Three Kinds 

(A) Corrosive poisons produce instant burning effect on all 
parts touched by them so there is staining of lips and mouth and 
burning pain in mouth, throat and stomach; straining and 
vomiting; also perhaps suffocation and always shock. 

(B) Irritant Poisons. —Such poisons irritate but do not cor¬ 
rode parts they touch. No staining; metallic taste; burning of 
mouth and throat and in stomach, straining, vomiting and 
purging. Shock. 

(C) Nerve poisons do not stain. Two classes: 

1. Narcotics. Produce deep sleep and insensibility. 

2. Convulsants. Produce convulsions, twitching, delirium 
and suffocation. (Some poisons are both irritant and nerve 
poisons.) 

(A) Corrosive Poisons. —Those which stain and for which an 
emetic is best not given. Strong acids: Sulphuric (oil of vitriol); 
hydrochloric (spirits of salt); nitric (aqua fortis). Strong 
alkalies: Caustic soda, potash and lime. 

Treatment.— 

1. Neutralize poison. 

2. Dilute poison and soothe corroded parts. 

3. Stimulants. 

(1) If acid, to neutralize give alkalies as plaster from ceiling, 
magnesia, baking soda or even soap. If alkalies, to neutralize 
give vinegar, lemon or orange juice. 

(2) To dilute and soothe for both acids and alkalies give large 
quantities of oil, any vegetable or animal oil, such as olive, salad, 
sardine, linseed, castor or cod liver oil; also water, milk, flour 
and water, or eggs beaten up. 


QUESTIONS 


II5 

(3) Stimulants: Strong tea and coffee, ammonia or alcohol. 

(B) Irritant Poisons. —Those which do not stain and for which 
an emetic is given. Tartar emetic, blue stone, Paris Green, lead, 
corrosive sublimate (antiseptic tablets) phosphorus and arsenic 
(rat poison and other vermin killers); poisonous plants. 

Treatment.— 

1. Emetic. 

2. Dilute poison and soothe parts. 

3. Stimulants. 

2. To dilute and soothe: As in corrosive poisons. But no 
oil in phosphorus poisoning. 

3. Stimulants: As above. 

(C) Nerve Poisons. —Do not stain and require an emetic. 

(1) Sleep producers: Opium, morphine, laudanum, paregoric, 
soothing syrups, powders, chlorodyne. At first very sleepy, 
later insensibility, pupils of eye very small, breathing deep, slow 
and snoring, face first flushed then livid, breath may smell of 
the poison. 

Treatment.— 

1. Emetic. 

2. Keep awake, strong coffee. Slap with wet towel. Walk 
up and down supporting on each side. Stop this if weak and put 
in lying-down position. 

3. Artificial respiration. 

(2) Convulsants. Strychnine, belladonna, prussic acid, etc. 
Strychnine is far more common. Is found in some vermin 
killers. 

Treatment. —In all these poisons must work very quickly. 
Emetic. Do not wait for it to be prepared but tickle back of 
throat with finger and keep it there till vomiting occurs. Artifi¬ 
cial respiration if breathing stops. 

QUESTIONS 

1. What is unconsciousness? 

2. To what causes is it most commonly due? 

3. Explain how you would make out the cause? 


Il6 UNCONSCIOUSNESS OR INSENSIBILITY. POISONING 


4. If you were unable to do this what would you do? 

5. Fainting; cause; prevention; symptoms and treatment? 

6. Symptoms and treatment of fits? 

7. Alcohohc poisoning, with what is it often confused and what 
should you do to prevent such a mistake? 

8. Treatment of alcoholic poisoning, 

9. Apoplexy and injury to the brain, symptoms and treatment? 

10. Symptoms and treatment of opium poisoning. 

11. Symptoms and treatment of carbolic-acid poisoning. 

12. What would make you think a person h,ad been poisoned? 

13. What different classes of poisons are there and the treatment of 
each class? 

14. What would you do if you thought a poison had been taken but 
could not find out what the poison was? 

PRACTICAL EXERCISES 

A general review which should include practical problems in first aid 
of general interest and of interest to the special class. As an example 
of a problem of the former kind the following is given; You are walking 
along a country road and find a man who has been thrown from his 
horse. He is unconscious, his right thigh and left arm are broken. 
Take care of him. 

Questions should always be asked in connection with the problems 
so that the instructor may rnake sure the members of the class clearly 
understand what they are doing and the reason for each step. 


CHAPTER IX 


HOW TO CARRY INJURED 

A man trained in first aid will find when he has treated an 
injury that his duty is usually but half performed. Accidents 
generally occur in places from which it is absolutely necessary 
to carry the injured, and unless the proper means for transport¬ 
ing them are understood and practised very serious harm may 
result to them. In fact, the benefits from good first-aid treat¬ 
ment may be undone by bad transportation. 

It should be understood, of course, that whatever method of 
transportation is adopted, first aid should be given before it is 
attempted, and that when necessary the clothing should be 
loosened so that it will not constrict the neck, chest or abdomen 
during transportation. 

The kind of transportation which should be furnished must, 
of course, vary widely with the character of the complaint. 
All serious cases of illness or injury should be carried on stretchers 
whenever it is possible to procure or to improvise them, and in 
case of doubt it is always much safer to carry the patient lying 
down. 


STRETCHER TRANSPORT 

The ordinary stretcher is so well known that it hardly need be 
described. It consists of two long poles with a bed, usually 
made of canvas, between them and cross-pieces to keep the long 
poles apart and thus to stretch the canvas. The poles are long 
enough to afford handholds for the bearers at each end of the 
stretcher. 

Fairly satisfactory stretchers may be improvised. That is to 
say, they may be put together on the ground with the materials 

117 


ii8 


HOW TO CARRY INJURED 


at hand. An easy one to make is the coat stretcher. For this 
two coats and a pair of poles are needed. The sleeves of the 
coats are first turned inside out and the coats are placed on the 
ground with their lower edges touching each other, the poles are 
then passed through the sleeves on each side, the coats are 
buttoned up and the buttoned side turned down. 

To make this stretcher in another way, a man should button 
the two top buttons of his coat or jumper, bend over, face the 
poles, holding them in his hands, and have his comrade pull 
the coat over his head onto the poles. Of course this must also 
be done at the other end of the poles. 

Two poles and a large blanket or rug may be used to make a 
stretcher. The blanket or rug is spread on the ground with the 
two poles on the edges of its long sides. These edges are then 
rolled on the poles till a distance of about 20 inches is left between 
them. This stretcher may be turned over before being used 
and, especially with narrow blankets or rugs, it is much safer to 
bind them to the poles with twine. With both these stretchers 
it is desirable, except for short transport, when it will hardly be 
necessary, to tie on two pieces of wood for cross-pieces so as to 
prevent the poles from approaching each other when the weight 
of the patient is put on the stretcher. 

Instead of rugs and blankets, bags and sacks may be employed 
for stretcher beds. The bottoms of the latter should be ripped 
so that the poles may be passed through the number sufficient to 
give the length of bed required. With these and similar stretch¬ 
ers, careful tests, by lifting an uninjured man, should be made 
before allowing them to be used for patients; care is also neces¬ 
sary to guard against accidents during transportation. 

Numbers of articles, some of which may almost always be 
easily procured, may also be used for stretchers in case of neces¬ 
sity. Such articles are doors, window shutters, boards, bed 
frames, benches, ladders, mattresses, rugs, blankets and mats. 

There are also some special stretchers. In many mines and 
on shipboard, injured men must sometimes be carried in the 
upright instead of the lying-down position. For this they are 
strapped to boards, frames, or wire baskets. 


CARRYING 


II9 



Plate XVIIL—Transportation. 



































120 


HOW TO CARRY INJURED 


Another apparatus which is very often found useful for carry¬ 
ing sick or injured is an ordinary chair. It is specially con¬ 
venient for women. The patient is seated in the chair and it is 
tilted back, the chair back being supported by one bearer and 
the front legs by another. 

Whatever the type of stretcher used, the greatest gentleness 
should be observed in transferring the patient to it, and unless 
he is to be subjected to unnecessary suffering all his bearers 
must work together. The necessity for bearers working together 
has been so thoroughly appreciated by the armies of the world 
that they all now give a regular stretcher drill to men charged 
with the duty of carrying wounded. At present, this drill 
somewhat changed for the purpose, is generally used in civil life. 

It is not absolutely necessary for every student of first aid to 
learn a drill but this is very desirable, as men knowing the drill 
can always work together better and without any confusion, to 
the great benefit of the patient. Moreover, if one form of drill 
is learned by all first aiders any man can take his part in this 
work wherever he may be. 

The drill given here is modified from that of the United States 
Army. 


STRETCHER DRILL 
Each Stretcher Squad Consists of Four Men 

Obtaining, Opening, Closing, and Returning the Stretcher 

The necessary commands for executing these movements will 
be given and the movements described, but as none of them has 
anything to do with actual carrying of the patient, and, therefore, 
does not demand that bearers work together at the word of 
command, their study and practice may well be omitted if the fol¬ 
lowing plan is adopted. First, each member of the squad must be 
given a number from i to 4. Any member of the squad is sent 
by No. I, the leader, to get the stretcher, to bring it to the patient, 
to open it, and to place it at the patient’s head in line with his 
body. Then at the command, At Patient’s Right (or Left); 


STRETCHER DRILL 


I2I 


Posts, all bearers take position as in movement 15, give first 
aid and proceed as described. Following the same plan as soon 
as the patient has finally been carried to his destination and the 
stretcher is no longer required, any member of the squad may 
be directed to close it and to dispose of it as desired. 

I. Fall In. —The four men form in line and count off, beginning 
with No. I at the right. No. i commands the squad and gives 
the orders. In his absence No. 4 takes command; if Nos. i and 4 
are both absent the duty falls on No. 3. 

2. Procure Stretcher; March. —No. 3 steps one pace to 
the front and, facing in the direction of the stretcher, proceeds 
thither by the shortest route, takes the stretcher and places it on 
his right shoulder. He then returns to his place in line. The 
order, of course, is given by No. i. 

It should be noted that most orders are in two parts. The 
former as in this case “Procure Stretcher” tells what is to be 
done. The latter, here “March” is the command of execution. 
When, and not until this is given, does the movement begin. 

3. Carry; Stretcher. —No. 3 drops the upper handles forward; 
No. 2 steps forward and catches the front handles with his left 
hand; Nos. i and 4 advance to the middle of the stretcher, to 
the right and left, respectively; Nos. 2 and 3 hold the stretcher 
between the hand and the hip, grasping the lower handles. 

4. Open; Stretcher. —Nos. 2 and 3 open the stretcher and 
stretch the braces, then lowering it to the ground. Nos. i and 4 
take positions opposite the center of the stretcher at the right 
and left respectively. No. 3 is between the handles at the rear 
and No. 2 at the front. 

5. Close; Stretcher. —The movements are reversed and the 
position of “Carry Stretcher,” is taken. 

6. Shoulder; Stretcher. —This movement is made from “Carry; 
Stretcher.” At “Shoulder” No. 3 places his left hand under the 
stretcher. At “Stretcher” No. 3 puts the stretcher on his 
right shoulder. No. 2, helping by jerking the front end upward. 
All take their positions. Nos. i, 2 and 4 stepping back in line 
with No. 3. 

7. Return Stretcher; March. —No. 3 with the stretcher on 


122 


HOW TO CARRY INJURED 


his shoulders marches to the place the stretcher is to be left and 
returiig to his place in line. 

8. Fall Out. —The squad is broken up. 

Marching with the Stretcher 

9. Forward; March. —The bearers all march straight to the 
front. Nos. i and 4 keeping their positions at the sides of the 
stretcher. All step off with the left foot if the stretcher is at a 
“ Carry. ” If the stretcher is “ Open ” with or without a patient, 
No. 3 steps off with his right foot. 

10. IncUne to the Right (or Left); March. 

A slight change of direction is made to the right or left as the 
command requires. 

11. Stretcher Right (or Left); March. 

A change in direction at a right angle to the previous line of 
march is made. 

12. Stretcher Right (or Left) About; March. —The change 
of direction is total instead of half as in ii. 

13. Take Posts to Load Stretcher; March. —Nos. i and 4 
run ahead and take positions at the patient’s right and left sides, 
respectively, examine the patient and give him first-aid treat¬ 
ment; Nos. 2 and 3 follow with the stretcher. This movement 
may be made from a halt but is usually performed in march. 

14. Lower; Stretcher. —Nos. 2 and 3 lower the stretcher one 
yard from the patient’s head and in line with his body. This 
command is given by No. 3. If the stretcher is not open before 
giving the command “Lower; Stretcher,” No. 3 commands 
“Open; Stretcher.” 


The Loaded Stretcher 

15. At Patient’s Right (or Left); Posts. —Nos. 2 and 3 take 
posts at patient’s right (or left) ankles and shoulders respectively, 
with No. I always at the right hip and No. 4 at the left hip. 
They then assist Nos. i and 4 in first-aid w’ork. When the 
patient is ready for the stretcher the next command given by 
No. I is: 


THE LOADED STRETCHER 


123 


16. Prepare to Lift. —All bearers kneel on the knee nearest 
the patient’s feet, right for his right and left for his left; No. 2 
passing both his arms under the patient’s legs; Nos. i and 4 pass¬ 
ing their arms under his loins and thighs; No. 3 passing one arm 
under his shoulders and the other under his neck to the further 
shoulder, thus supporting the head. In case of a fracture, the 
bearer nearest to it supports the part and looks after it. 

17. Lift; Patient. —All lift together and raise the patient 
slowly and gently to the knees of the three bearers who are in 
line; then the odd bearer. No. i or 4, rises and passing by the 
shortest route to the stretcher, grasps it by the middle, one pole 
in each hand, and places it in front of the bearers and against 
their ankles. 

18. Lower; Patient. —No. i or 4 stoops and assists the other 
bearers to lower the patient gently to the stretcher and then all 
resume their respective posts. 

As patients are usually carried feet first No. 2 will take post 
at the foot end of the stretcher and No. 3 at the head end between 
the poles. No. i is opposite the right hip and No. 4 opposite 
the left hip. 

19. To Carry Head First; March. —This command is neces¬ 
sary when for some good reason the patient is to be carried head 
first. All take the same positions but face about. This will 
still leave No. i at the patient’s right hip. No. 4 at the left hip. 
No. 2 at the feet and No. 3 at the head but the positions of all 
in reference to the marching stretcher will of course be reversed. 
This command is best given as soon as the bearers have taken 
their posts. 

20. Prepare to Lift; Lift. —At Prepare to Lift,,Nos. 2 and 3 
stoop, place the slings over their shoulders—if the stretcher 
has slings—grasp the handles and at the word lift they rise and 
stand erect. 

21. Forward; March. —With the loaded stretcher the bearers 
march with a short, sliding step of about 20 inches; Nos. i, 2 and 
4 step off with the left foot and No. 3 with his right, forming a 
“break step.” The patient, as stated, is usually carried feet 
first. For change in direction see 10, ii and 12. 


124 


HOW TO CARRY INJURED 


2 2. Halt; Lower Stretcher. —Nos. 2 and 3 lower the stretcher 
gently to the ground. When lowering or lifting a stretcher, the 
rear bearer must always watch the front bearer and move simul¬ 
taneously with him. 

23. At Patient’s Right (or Left); Posts.— At the command 
“Posts” positions are taken in 15. 

Unloading the Stretcher 

24. Prepare to Lift. —The bearers, standing at their respective 
posts, kneel and adjust their hands as in lifting to load the 
stretcher. 

25. Lift; Patient. —The bearers lift the patient to their knees 
and No. i removes the stretcher. 

26. Lower; Patient.— Nos. 2, 3 and 4 or i lower him to the 
ground, or, if he is to be put on a bed, they rise from their knees 
and side-step to the bed, the stretcher having been placed one 
yard away and in line with the bed, with the head of the patient 
toward the bed. 

When there are only three bearers, the patient is lifted or 
lowered to the knees of two, while the third places or removes the 
stretcher; or he may be carried on a two-handed seat, his legs 
being supported by the third bearer. 

Position of Patient on the Stretcher 

The position of a patient on the stretcher depends on his 
injury. An overcoat, blanket, or other suitable and convenient 
article should be used as a pillow to give support and a slightly 
raised position to the head. If the patient is faint the head 
should be kept low. Difficulty of breathing in wounds of the 
chest is relieved by a sufficient padding underneath. In wounds 
of the abdomen the best position is on the injured side, or on the 
back if the front of the abdomen is injured, the legs in either case 
being drawn up, with a pillow or coat placed under the knees to 
keep them bent. 

In an injury of the arm calling for stretcher transportation, 


TO CROSS AN OBSTACLE 


125 


the best position is on the back with the injured arm laid over the 
body or placed by its side, or on the uninjured side with the 
wounded arm laid over the body. In injuries of the legs the 
patient should be on the back; in cases of fracture of either leg, 
if a splint cannot be applied, it is always well to bind both legs 
together. 


To Cross an Obstacle 

Halt and lower the stretcher about 3 feet back from the 
obstacle. 

27. To Cross Obstacle; March. —No. i at the right and No. 2 
at the left grasp the right and left poles of the stretcher respec¬ 
tively at the forward end, while Nos. 3 and 4 do the same thing at 
the rear end. 

28. Prepare to Lift; Lift. —At ‘dift,” all lift the stretcher and 
move forward to rest the front end on the obstacle. 

No. 2 climbs over the obstacle and receives the stretcher as 
it is passed over to him; Nos. i and 4 then climb over and again 
taking the stretcher poles pass it entirely over the obstacle, and 
lower it to the ground. No. 3 who has been holding the head 
of the stretcher now climbs over, they all resume their former 
positions and proceed, the proper command being given. 

Transportation across a ditch is effected by Nos. i and 4 
bestriding the ditch in a narrow place, or descending into the 
ditch to support the stretcher. If the ditch is deep and wide, 
the stretcher must be halted and lowered with the handles near 
the edge; then Nos. i and 4 descend and proceed as before. 

To Load an Ambulance or Wagon 

Carry the stretcher to within i yard of the rear of the ambu¬ 
lance, about march, halt, and lower the stretcher to the ground; 
Nos. I and 3 take positions at the patient’s left and right shoul¬ 
ders, respectively. At the command prepare to load No. 2 
faces about and stooping, grasps his handles, and Nos. i and 3 
the poles on their respective sides. No. 4 opens the doors and 
sees that everything is in proper condition. 


126 


HOW TO CARRY INJURED 


At the command load, the bearers lift the stretcher to the 
height of the ambulance floor and advance, keeping the stretcher 
level. The legs of the stretcher are placed on the ambulance 
floor by Nos. i and 3, the stretcher is pushed in by No. 2 assisted 
by the others. 

Whenever it is possible all the bearers should accompany the 
ambulance, Nos. i and 3 occupying the seats inside. No. 2 inside 
at the patient’s head, and No. 4 standing on the footboard out¬ 
side. 


To Unload an Ambulance or Wagon 

At the command prepare to unload, No. 4 opens the doors 
if necessary, No. 2 grasps the handles of the stretcher and at the 
command unload, draws out the stretcher, assisted by Nos. i and 
3 who, facing inward, support the poles until the inner handles 
are reached. The stretcher must be kept level and lowered about 
a yard from the vehicle. Then No. 4 closes the doors and all 
take their posts at the stretcher. 

General Directions 

In moving the patient either with or without the stretcher, 
every movement should be made deliberately and as gently as 
possible, taking special care not to jar the injured part. The 
command steady will be used to prevent undue haste or other 
irregular movements. 

The loaded stretcher should never he lifted or lowered without 
orders. 

Should your patient have a broken bone be particularly care¬ 
ful that he is not jolted. A little intelligent care will prevent 
this. 

Never carry a stretcher on your shoulders. 

Always carry a patient feet forward except: 

I. When going uphill with a patient whose lower limbs 
are not injured. 


GENERAL DIRECTIONS 


127 


2. When going downhill with a patient whose lower 
limbs are injured. 

In such cases carry headforemost. Keep the stretcher 
as level as possible. 

In transferring a patient from a stretcher to a bed as the most 
convenient method is to lift the patient over the foot of the bed 
the stretcher should, of course, be lowered at the foot of the bed 
in line with it with the patient’s head toward the bed. As there 
is rarely space in a room to change ends of the stretcher, this 
should ordinarily be done outside and the stretcher carried to the 
bed with the patient headforemost. 

Wherever obstacles are in your path go around them, for 
every time a patient is set down or lifted it gives him additional 
pain. 

Only when the crossing of obstacles is unavoidable, as where 
a fence cannot be torn down, a breach cannot be made in a brick 
wall or cars cannot be gotten out of the way should they be 
crossed as already provided. 

Accompanying all accidents there is a certain amount of 
shock, which gives a sensation of cold, so that even at midsummer 
injured men sometimes shiver with cold. Therefore, it is impor¬ 
tant that the patient be well covered with blankets or whatever 
clothing may be handy, whether the season be summer or winter. 

All commands should be given in a low tone, but distinctly 
enough to be heard by all the bearers. 

It should be the duty of the bearers to keep at a respectful 
distance the curious people who are always attracted by accidents, 
who ask questions, shut out fresh air and do many other things 
bad for the patient. 

Time being an essential factor in accidents, the patient should 
be carried to his home or a hospital without unnecessary delay. 
With this end in view, an ambulance driver should drive as fast 
as. the condition of the road and comfort of the patient will per¬ 
mit, exercising special care and driving slower where the road is 
bad. 

It is also important that a physician be notified as early as 


128 


HOW TO CARRY INJURED 


possible, and that at the same time he be informed of the nature 
of the accident. Due attention to this matter may prevent 
fatal results. 

When wagons or other vehicles must be used in place of an am¬ 
bulance always, if possible, put plenty of straw, leaves, or boughs 
on the floor so as to reduce the jolting. 

TRANSPORTATION WITHOUT A STRETCHER 

Not infrequently in accidents it will not be possible to procure 
a stretcher for the patient. The first-aid student should there¬ 
fore learn what to do under such circumstances as ignorance in 
this particular may subject the patient to risk of further injury 
and to a great deal of unnecessary pain. 

With Two Bearers 

If the injured person is unable to walk, has not lost conscious¬ 
ness, and can use his arms, a good plan to adopt is the four- 
handed seat or “lady’s chair” of children. To form it two men 
grasp each his left wrist with his right hand, and with his left 
hand grasps his fellow’s wrist. Seated on the seat so formed, 
the patient throws his arms over the shoulders of the bearers. 

A two-handed seat is more comfortable, both for the patient 
and the bearers. The right-hand bearer grasps with his right 
hand the left wrist, and with his left hand the right shoulder of 
his fellow-bearer; the left-hand bearer grasps with his left hand 
the right wrist of his fellow, and with his right hand the left 
shoulder. 

Still another method which requires no effort on the part of the 
patient, but is not applicable to severe injuries of the limbs, is 
called carrying by the extremities. For this one bearer takes 
position between the patient’s legs and the other at his head, 
both facing toward his feet. 

The rear bearer raises the patient to a sitting position, clasps 
him from behind around the body under the arms, while the front 
bearer, standing between the legs, passes his hands from the out¬ 
side under the bent knees. Both rise together. 


CARRYING 


129 



9 




































130 


HOW TO CARRY INJURED 


With One Bearer 

There are four methods for this: 

1. The bearer assists the patient to walk. 

2. The patient is carried in the bearer’s arms. 

3. The patient is carried across the bearer’s back. Firemen’s 
Lift. 

4. The patient is carried astride the bearer’s back. 

No. I, Assisting to Walk 

The patient is probably suffering from a comparatively slight 
injury of the upper part of the body and his legs uninjured. 
If he can stand, stand by his side; put his sound arm over your 
shoulder and behind your neck; grasp his hand with your own 
and pass your other arm around his waist to support him. A 
single bearer may thus, if necessary, assist two slightly injured 
persons. To get him in the standing position, if it is necessary 
to raise him from the ground, the bearer should act as described 
in the next paragraph. 

No. 2, Carrying in Arms 

The patient is lying on the ground probably insensible, and 
totally helpless. The bearer, turning patient on his face, steps 
astride his body, facing toward the patient’s head, and with 
hands under his arm-pits lifts him to his knees; then clasping 
hands over abdomen, lifts him to his feet; he then with his left 
hand seizes the patient by the left wrist and drawls left arm around 
his (the bearer’s) neck and holds it against his left chest, the 
patient’s left side resting against his body, and supports him 
with his right arm about the waist. 

From this position the bearer with his right arm upon the 
patient’s back passes his left under thighs and lifts him into posi¬ 
tion, carrying him well up. This method is very easy for the 
patient but hard on the bearer; therefore, it is used only when 
the patient is insensible and it is not necessary to carry him far. 


CARRYING ASTRIDE THE BACK 


I3I 


No. 3, Carrying Across Back: Fireman’s Lift 

The patient is first lifted erect as described in previous para¬ 
graph, when the bearer with his left hand seizes the right wrist 
of the patient and draws the arm over his head and down upon 
his left shoulder, then shifting himself in front, stoops and clasps 
the right thigh with his right arm passed between the legs, his 
right hand seizing the patient’s right wrist; lastly the bearer 
with his left hand grasps the patient’s left and steadies it against 
his side, when he rises. This method is comfortable for the 
patient and easy for the bearer and is particularly recommended 
when the patient is not insensible, but is unable to render his 
bearer any assistance. 

No. 4, Carrying Astride of Back 

The patient is lifted erect (as described), when the bearer 
shifts himself to the front of the patient, back to the patient, 
stoops and grasping his thighs, brings him well upon his back. 

As the patient must help himself by placing his arms around 
the bearer’s neck, this method is impracticable with an uncon¬ 
scious man. 

In lowering the patient from these positions the motions are 
reversed. Should the patient be injured in such a manner as to 
require these motions to be conducted from the right side instead 
of left, as laid down, the change is simply one of hands—the 
motions proceed as directed, substituting right for left and vice 
versa. 

A patient astride the back of a bearer may, when necessary, 
be carried up a ladder, though with considerable difficulty. A 
better method is sometimes used, especially in mines. This 
requires an apparatus which consists of a wide belt which is held 
just below the armpits of the bearer by suspenders over the 
shoulders. From the belt a wide band leads to join the belt 
on the opposite side. The patient sits in this band supporting 
himself partially by his hands on the bearer’s shoulders. 


•132 


HOW TO CARRY INJURED 


QUESTIONS 

1. When would you use a stretcher for a patient? 

2. What position would you put the patient in on a stretcher? 
Usually; if fainting; if abdomen is injured; if leg is broken? 

3. When is command steady given? 

4. Is patient carried head or feet foremost? 

5. What would you do to prevent shock to patient on stretcher? 

PRACTICAL EXERCISES 

(In all these exercises in which the services of more than one man are 
required, one man should be selected to take charge and should give 
the necessary directions to his assistants.) 

1. Make a coat stretcher. 

2. Obtain, Open, Close and Return Stretcher. 

3. March with Stretcher. 

4. Load Stretcher. 

5. March 10 feet and lower stretcher. 

6. Unload stretcher. 

7. Cross a wall with loaded stretcher. 

8. Load an ambulance, or wagon. 

9. Unload an ambulance, wagon. 

10. Carry a patient with two bearers. 

11. Assist patient to walk. 

12. Carry in arms. 

13. Carry across back. 

14. Carry astride of back. 


CHAPTER X 


MINERS’ FIRST AID 

Safety. Care of Injured 

While the fatal and non-fatal accidents in mines have somewhat 
decreased of recent years, the rates for both are still very high. 
This subject has been carefully studied by the Federal Bureau of 
Mines to whose publications indebtedness is acknowledged for 
the figures given here. 

‘‘During the calendar year 1912 there were 2360 men killed 
in and about the coal mines of the United States. Based on an 
output of 550,000,000 short tons of coal produced by 750,000 men, 
the number of men killed for every 1,000,000 tons of coal mined 
was 4.29, and the death rate per 1,000 employed was 3.15 (these 
figures are subject to slight revision).” 

“There were 233,000 tons of coal mined for each man killed 
in 1912.” This shows a considerable improvement since 1907 
during which 3,197 men were killed, representing one death for 
every 144,000 tons mined. 

The report of the Bureau of Mines from which the above quo¬ 
tations are made states very truly that a still greater reduction 
in the death rate can be effected, and that in order to accomplish 
this all concerned must unite in preventing dangerous conditions 
and in avoiding unnecessary risks. To this might be added with 
equal truth:.and by the proper treatment of injured from the 
moment of injury in order to prevent bad results therefrom. 

The figures given in,the same report for non-fatal accidents are 
for the year 1911. 9,106 serious injuries and 22,228 slight injuries 

were reported for that year. As was the case with fatalities, 
the larger part (43.57 per cent.) of the serious injuries were due 
to falls of roof and coal. The second cause in importance was 
mine cars and mine locomotives. 


133 


134 


MINERS FIRST AID 


That lessening the number of fatal and non-fatal accidents in 
mines and the bad effects from the latter when improperly treated 
is not wholly a humanitarian question is evident from some fig¬ 
ures which appear in the same report. Assuming that each life 
lost was worth $5000.00, the total loss represented by the fatal 
accidentsin 1911 (2,719) was $13,595,000. If the non-fatal acci¬ 
dents were also taken into consideration the total loss for this 
year alone would be more than fourteen millions. Still more 
convincing figures of the money value of the prevention of acci¬ 
dents and fatal results therefrom is afforded by the figures for 
the seventeen years from 1896 to 1912. Without taking into 
consideration the non-fatal accidents and reckoning the fatal 
at a loss of $5000 each, the total loss occasioned by such fatal 
accidents was $168,000,000. 

While the figures for the metal mines are very incomplete, they 
are sufficient to show that conditions in respect to accidents 
in them are even worse than in the coal mines. For the year 1911, 
in the metal mines 4.19 men per thousand were killed as com¬ 
pared with 3.73 killed per thousand in the coal mines. 

It is not proposed that time be spent in consideration of these 
figures, nor is this necessary. It would be a very ignorant man 
who could not understand their meaning. This, of course, is that 
we still have much too many deaths and injuries from accident 
in our mines. If this condition were without remedy we would 
have to accept it, bad as it is, but this is not the case. We know 
that in other countries and in individual mines in our own country 
in which conditions are not naturally exceptionably favorable 
that much better showings are being made. Now, how has this 
been done; in two ways, by safer mining and by better care of 
injuries, some of which must occur under the best conditions. 
Safety will be discussed first. 

SAFETY 

Safety falls naturally under two heads: i. Safety appliances; 
2. the care shown by miners themselves. 

The second is what we are most interested in. It is said that 


SAFETY 


135 


the best safety appliances will not prevent over one-third of the 
injuries in our industries, generally, and it is doubtful if they are 
relatively as important in this so far as mining is concerned. At 
all events it is clear to what a very great extent the prevention of 
accidents is in the hands of the miners themselves. Their 
success is dependent in the first place on the attitude of miners in 
regard to their own safety and the attitude of bosses and operators 
toward the whole question. That this is improving is the cause 
of some lessening in the number of injuries of recent years, that 
is to say, it is the main cause; better appliances have also helped 
somewhat in the same direction. Too often yet, however, we 
find an inclination to make light of the whole matter of safety. 
Some miners, and too often among them the best and most intel¬ 
ligent in other respects, seem to think that looking after their 
own safety is being cowardly and are afraid that other miners 
will laugh at them, if realizing the dangers connected with mining, 
they try to prevent accidents. Now, of course, there is no sense 
in such an attitude, being foolhardy is not being brave and does 
not merit praise but the services of the fool-killer. It is not a brave 
thing to take a chance which may not only put your own family 
in want but may also do the same for the families of other miners 
who are in no way to blame. Nor is this fair play. 

The duty of bosses and foremen is to discourage dangerous 
practices at all times and to try to get into the minds of everybody 
concerned the idea of safety. There are many ways in which 
operators may show their interest in safety. Any reward given 
for specially good safety work will generally be richly repaid. 
First aid and safety contests are discussed later. 

Now what are the two main causes of accidents? They are 
ignorance and carelessness. 

Ignorance.—This does not mean a lack of intelligence. For 
example, a man wholly ignorant of mining might know every¬ 
thing there was to know about something else. It means ig¬ 
norance of the precautions which experience has shown it is 
necessary to take in order to prevent accidents. Everyone 
responsible should take every care so that all miners may know 
what practices are dangerous. This is not always the case even 


136 


miners’ first aid 


with men who have worked in mines all their lives. When they 
started they saw something done in a dangerous way and they 
have always done it in just that way because they have never had 
the chance to learn a safer way. This information can be given in 
part at meetings held from time to time. It is believed, and a 
large experience has shown this to be the case, that safety and 
first aid to the injured should be taught together. The advan¬ 
tages of this plan are many. The most important are: safety is 
a pretty dull subject and first aid has always proved a most inter¬ 
esting one to miners. Anyone when he takes care of an injury or 
studies about it will think what caused it and this will make him 
more careful. As a matter of fact in numbers of mines the 
injuries of miners who have learned first aid average about a 
quarter those of their comrades who have not had this instruction. 
Moreover, if first-aid teaching is combined with safety teaching 
it is much easier to keep the subject of safety prominently in the 
minds of all. This may be done by first-aid and safety contests 
and by awarding medals for good work in either and like means. 
If it is not thought desirable to teach all miners first aid, select 
some of the most intelligent for such instruction but have safety 
meetings for all together. 

In most mines warnings against unsafe practices are posted 
in prominent positions. These are often in several different 
languages. Those of a mine in the anthracite region of Pennsyl¬ 
vania slightly modified will be given here. Due to the kindness 
of the Coal Department of the Delaware, Lackawanna and 
Western Railroad Co., illustrations of the more common mine 
accidents also appear. These were published originally in a 
pamphlet entitled “Mine Accidents and their Prevention” 
for which the pictures were taken by W. B. Bunnell, official 
photographer for the railroad in question. This pamphlet 
was prepared by J. S. Dagiie and S. J. Phillips, Secretaries for 
the Education of Mine Workers, Y. M. C. A., Scranton, Pa. 
This was done under the direction of R. A. Phillips, Superintend¬ 
ent, and C. E. Tobey, Assistant Superintendent, Coal Mining 
Department, Delaware, Lackawanna and Western Railroad 
Company, Scranton, Pa. - 


don’ts 


137 


Indebtedness to the Bureau of Mines is also acknowledged 
for a few illustrations which appear with the others. They are 
specially marked. 


Don’t 

The Fire Boss 

Don’t fail to see that your orders are obeyed promptly. 

The Miner 

Don’t hurry to the face until the smoke has cleared away. 
Don’t forget to sound the roof after each blast. 

Don’t undermine top coal or top rock to the extent of more 
than one row of shots. 

Don’t permit your laborer to unload coal until you have 
replaced dislodged timber. 

Don’t conclude the roof is safe in spite of drummy sound. 
Don’t take a lighted pipe or lamp to your powder box. 

Don’t forget to keep your laborer and his pipe at a respectful 
distance when you are handling explosives. 

Don’t shorten your squid or put oil on it. 

Don’t put sulphur and gas squids in the same place. 

Don’t fire two holes at one time. 

Don’t pass over danger signals. 

Don’t hurry in order to get out early. 

Don’t risk your life to save labor. 

Don’t forget the miner is responsible for the safety of the 
laborer. 

Don’t fail to use a safety lamp when there is gas. 

Don’t fail to make the chamber or room safe before you go 
home. 


The Laborer 

Don’t go into the face until the miner has examined it and pro¬ 
nounced it safe. 


miners’ first aid 


138 

Don’t fire blasts for the miner or in the absence of the miner. 
Don’t disregard the orders of the miner. 

Don’t run cars out from the face. Let the runner come for 
them. 

Don’t roam through old workings. 

Don’t walk haulage roads, go the manway. 

Don’t forget to close all doors as you pass through. 

Don’t forget to retreat to a place of safety when blasts are 
about to be exploded. 


The Runners 

Don’t allow drivers to run cars. Run them yourself. 

Don’t ride between cars in a moving train. 

Don’t ride on the side of the car. 

Don’t allow the drivers to make flying switches. 

Don’t ride on the front bumper of mine cars. 

Don’t run cars on a grade until you know it is clear below. 
Don’t forget the headblocks are to be put on for the protection 
of runners and drivers. 

Don’t forget to call attention of the driver boss to bad roads. 

Drivers 

Don’t take the doorboy away from his post to drive your mule. 
Don’t ride the bumper trailing your feet along the road. 

Don’t forget that a blast follows an alarm. 

Trappers or Door Boys 

Don’t leave your door. 

Don’t allow your door to remain open longer than necessary. 
Don’t run around after, mules. 

Footman or Cager 

Don’t fail always to make everything safe before you give the 
signal. 


EXAMINE ROOF OR TOP 


139 


DON’T FAIL TO EXAMINE THE ROOF OR TOP AFTER EACH 

SHOT. 



Fig. I. —Examining results of shot. 



Fig. 2.—Fall of roof on miner. 








140 


miners’ first aid 




Fig. 4.—Miner and laborer pull down roof. 









KNOCK OUT PROPS WITH DYNAMITE 


I41 



Fig. $■—Miner examines face in safety. 


NEVER KNOCK OUT THE PROP WITH THE HAMMER. 
KNOCK OUT PROPS WITH DYNAMITE. 



Fig. 6.—Miner knocks out prop with hammer. 




142 


miners’ first aid 




Fig. 8 .—Preparing to blow out prop with dynamite. 







MAKE THE ROOF SAFE 


143 



DON’T FAIL TO MAKE THE ROOF SAFE. 






144 


miners’ first aid 



Fig. II.—Laborer loading the coal. 



Fig. 12 .—Laborer covered by fall of roof, 












MAKE THE ROOF SAFE 


145 



Fig. 13.—Standing prop under bad roof. 



Fig. 14.—Barring down bad roof. 


10 









146 


MINERS FIRST AID 


DRIVER, DON’T SLIDE YOUR FOOT ON THE RAIL. 



Fig. 15.—Driver sliding foot on rail. 



Fig. 16.—Foot entering frog. 







STANDING OF PROPS 


147 



Fig. 17.—Driver’s foot under car. 


MINER, DON’T STAND PROPS LESS THAN THREE EEET 
FROM THE ROAD. 



Fig. 18.—Runner between prop and car. 







148 


miners’ first aid 



Fig. 19.— Miner standing prop with gauge. 



Fig. 20.—Runner between derailed car and props. 






EXAMINE BRAKES AND SAND 


149 


MOTORMAN, BE SURE THE BRAKE AND SAND ARE .ILL 

RIGHT. 

BRAKEAIAN, EXAMINE THE BRAKES AND SAND BEFORE 
STARTING DOWN A GRADE. 



Fig. 21.—Motor derailed at foot of grade due to failure to examine brakes and 

sand. 



Fig, 22.—Helper examines sand and brakes at top of grade. 









illNEKS’ riRST AID 


150 



Fig, 23.—Motor safe at foot of grade with trip. 


DRIVER, DON’T RIDE BACKWARD ON THE TRIP—.\LWAYS 
RIDE WITH YOUR FACE TOWARD THE FRONT. 



Fig. 24.—Driver riding on bumper with back turned tow'ard front. 






don’t ride backward on trip 


151 



Fig. 25.—Driver knocked from bumper. Fallen under car. 



Fig. 26.—Driver riding on bumper with face turned forward. 






152 


MINERS FIRST AID 


DOORBOY OR TRAPPER, NEVER TRY TO GET ON THE 
]MOTOR—ALWAYS KEEP IN A SAFE PLACE. 



Fig. 27.—Doorboy or trapper under motor. 



riG. 25 .—uoorDoy or trapper standing in place of safety. 






153 


A “miss” shot 

DON’T GO BACK TO THE FACE AFTER A “MISS” SHOT— 
.ALWAYS GO HOME. 



Fig. 29.—Delayed shot goes out just as miner returns to face. 



Fig. 30.—Miner putting up notice after a “miss” shot. 





154 


MINERS FIRST AID 



Fig. 31.—Miner reporting a miss-fire before going home for the day. 


NEVER FIRE MORE THAN ONE SHOT AT A TIME. 



Fig. 32.—Miner preparing two holes, 
















FIRE ONE SHOT AT A TIME 


I 



Fig, —Miner lighting two holes. 



Ol 

Ol 








156 miners’ eirst aid 

DON’T FORCE THE CARTRIDGE OR STICK OF POWDER 
INTO THE HOLE. 



Fig. 35.—Forcing cartridge into hole with drill. 



Fig. 36.—Cartridge exploded and miner injured. 









FIRING SHOT 


157 

DON’T FIRE UNTIL YOU NOTIFY THE MEN IN THE NEXT 

PLACES. 



Pig. 37.—Miner firing shot. 



Fig. 38. —Miner coming through cross cut caught by blast. 






MINERS FIRST AID 


158 



Fig. 39.—Notifying men in adjoining places. 


NEVER OPEN A POWDER KEG BY PUNCHING A HOLE 
WITH A PICK. DON’T CARRY POWDER IN A PAPER 

BAG. 



Fig. 40. 

Courtesy Federal Bureau of Mines. 


Fig. 41. 









POSITION OF LAMP 


159 


.U.WAYS KEEP THE LAMP FIVE FEET FROM THE 
EXPLOSIVE. 



Fig. 42.—Miner preparing cartridge with lamp on head. 










i6o 


miners’ first aid 



Fig. 44.—Preparing cartridge with lamp at a safe distance. 


DON’T THAW DYNAIMITE WITH A LAMP. 



Fig. 45.—Thawing dynamite with a lamp. 





SAFETY CONTACT BATTERY 


l6l 



Fig. 46.—Dynamite exploded. 


A SAFE METHOD. 

A DANGEROUS PRACTICE. 



Fig. 47.—Hall’s safety contact 
battery. 

Courtesy Federal Bureau 


Fig. 48.—Crimping cap on 
a fuse with the teeth. 

of Mines. 





i 62 


MINERS FIRST AID 


IT IS NEVER SAFE TO CROSS OVER A TRIP OF CARS 



Fig. 4y.—Crossing trip of cars with keg of powder on shoulder. 



Fig. 50.—Miner thrown betw'een cars by result of shock. 










CARRYING OF DRILL 


163 



Fig. 51 


.— Miner walking around end of trip. Powder keg under his arm. 


DON’T CARRY A DRILL ON YOUR SHOULDER. 



Fig. 52 .—Miner with drill on shoulder walking under trolley wire. 








164 


MINERS FIRST AID 



Fig. 53. — Drill struck wire. Miner thrown to ground. 



Fig. 54. —Carrying drill in hand by side. 










GAS 


165 

DON’T CARRY AN OPEN LIGHT WHERE THERE IS GAS. 



Fig. 55.—Miner going from box to face with safety and naked lamps. 



Fig 56.—Miner at face with naked lamp at his.head. 









miners’ first aid 


166 



Fig. 57.—Explosion of gas at face. 

Carelessness. —This, as has been stated, is the cause of a good 
many avoidable accidents. The results are the same whether 
carelessness takes the form of recklessness or of thoughtlessness 
or indifference. There is no hope of stopping carelessness unless 
all wake up to the importance of safety. This subject has already 
been discussed. 


CARE OF INJURED 

As has been stated, instruction of miners in first aid to the 
injured results in the prevention of accidents. Besides dimin¬ 
ishing suffering it likewise prevents bad results from accidents 
thus often preventing death or permanent disablement. The 
value of first aid cannot be estimated in dollars and cents, for it 
goes way beyond that, but it does have a big money value. In 
a certain region in this country where first aid has been well 
taught the disbursements by benefit associations have been cut 
in half. The St. John Ambulance Association in Great Britain 
has had the longest experience in teaching first aid and the state¬ 
ment is made that at some collieries the shortening of the length 






CARE OF INJURED 


167 


of disability alone has more than paid for the very large outlay 
in training in first-aid knowledge and provision of ambulance 
material and temporary dressing stations. It should be explained 
that the British have a Compensation for Accidents Act. Of 
course, this is exactly the same result as that of our benefit 
associations. 

In a certain group of mines in this country first-aid in¬ 
struction plus some better safety appliances doubled the num¬ 
ber of tons mined per death from accident in the course of 
two years’ time. In no other occupation is intelligent first aid 
more needed than in mining nor can more good be accomplished 
by it. Mining accidents occur under the worst conditions, far 
from doctors and hospitals, perhaps a mile or so from the mine 
shaft or opening, and several hundred feet underground, and if 
the accident is caused by a fall of roof or an explosion the passage 
ways are blocked up by falling materials and the exit may be 
totally barred. Also the surroundings are dirty and means of 
transporting the injured are lacking and even if the way of exit 
is fairly clear the transportation of the injured man is necessarily 
slow and tedious. Usually from one to two hours elapse before 
the injured man can be gotten out of the mine and perhaps an 
equal period before he can be gotten to his home or to a hospital. 

It can readily be seen what could happen during that time if 
nothing were done for him in the line of first aid. Among the 
things that might occur would be death from bleeding or shock; 
a simple fracture made open or compound by ignorant handling 
or so twisted and deformed that it would be difficult to reduce. 
Wounds become infected from dust and handling and the patient 
may arrive at the doctor’s or at a hospital in such a weakened 
condition that he will die or his recovery will be doubly prolonged. 

Then contrast this picture with an injured man who had fallen 
into the hands of trained and intelligent first-aid men—the bleed¬ 
ing would be stopped by the proper application of a compress or 
tourniquet. His wounds would be cleanly dressed, his broken 
leg would have a temporary splint properly applied so that no 
deformity could occur, his pain would be relieved; he would be 
covered warmly with blankets, the shock would be almost 


i68 


miners’ first aid 


nothing, and he would go into the doctor’s or the hospital a 
stronger, safer, and better patient in every way. 

Character of Mining Injuries. 

Naturally there are many different kinds of injuries depending 
on the particular cause. Common causes of injuries in mines 
are falls of rock, coal or ore; explosion of gas or powder; from 
being struck by mine cars or when mules are used by kicks 
from them; electric shock. 

Nearly all the wounds received are crushed, mangled, ragged 
and torn and with them there is almost always a broken bone. 
Fractures are common and are often compound because of the 
very heavy weights which fall on the body or on the arms or 
legs. The bones are not infrequently broken in several places. 
Fracture of the skull is not an uncommon injury. The large 
rough pieces of rock and coal not rarely force clothing, coal or 
rock into wounds. The life is not infrequently totally mashed 
out of the flesh or tissues. This with the particles ground into 
them makes infection and blood-poisoning common. 

Shock is almost always severe and is the more dangerous as 
miners must frequently be carried considerable distances before 
it can be treated under favorable conditions. 

In mines we see terrible burns from gas, dust explosions, con¬ 
tact with electric currents, and explosions of powder and dyna¬ 
mite, and these burns (powder) are very frequently associated 
with large, gaping, and mangled wounds due to the flying pieces 
of metal, rock or coal. In fact, the injuries produced by a miner 
being “shot” are the duplicates of the effects on a man’s body 
of a bursting shell from modern artillery. 

Naturally, suffocation from noxious gases is common. 

Treatment.—No new principles are involved. While injured 
should be promptly removed from the place of injury, they can 
usually be properly prepared for transport before being moved. 
The judgment of rescuers must be exercised in this as well as in 
other respects. 

Shock is always to be remembered and treated. 


FIRST-AID SUPPLIES 


169 


The individual emergency supplies should be as simple as 
possible, as the conditions in mines are such that elaborate 
equipment cannot be carried. A miner going to render aid 
to a comrade with two Red Cross first-aid outfits for wounds, 
a packet of picric acid gauze for burns and a flask of aromatic 
ammonia for shock is well supplied. When two rescuers are 
available, under ordinary circumstances a stretcher should be 
carried. 

Suffocation is one of the greatest dangers associated with mine 
accidents. It is therefore always necessary to remove injured 
persons or suffocated persons to a place where purer air can be 
obtained. Artificial respiration will often be required. The 
pulmotor is a valuable apparatus much used in mines for this 
purpose. If no pulmotor is obtainable, the ordinary methods of 
artificial respiration must be resorted to. 

In order that rescuers may enter a mine chamber filled with 
dangerous gases it is necessary that they be equipped with 
the oxygen helmet or some other satisfactory form of respira¬ 
tory apparatus. It is also necessary that rescue parties be 
well instructed in transp>orting patients, for otherwise they 
cannot remove the injured and suffocated as promptly as is 
necessary. 

Severe mining injuries like other injuries of the same class 
require care from a doctor as soon as he can be obtained. 

A few words respecting the carrying of men in narrow shafts 
will be found in the chapter on carrying injured. 

First-aid Supplies for Mines 

While these supplies may be simple and should be so, on the 
other hand, high-class first-aid work is impracticable without the 
proper materials. The American Red Cross recommends the 
following supplies for mines: 

First-aid packets. Red Cross; one for every 20 men employed. 

First-aid packets. Red Cross, for outside; one for every 20 men 
employed. 

First-aid burn packets, picric acid gauze, one for every 25 
men employed in the gaseous mines. 


miners’ eirst aid 


170 

Plain gauze, in one-yard pasteboard packages; one package to 
every 25 men employed. 

Plain gauze bandages, assorted widths from 2 ^ to 3"; one 
bandage for every 20 employees. 

Plain unbleached muslin bandages, assorted widths from 2 ^ 
to 6"; two for every 20 employees. 

Plain unbleached muslin triangles, regulation size; one for every 
25 men employed. 

Absorbent cotton, in half-pound packages; three packages foi 
each mine hospital and outside cabinet. 

One 6 oz. bottle aromatic spirits of ammonia for each mine 
opening. 

Six canvas strap tourniquets. Red Cross, for each mine opening. 

Three sets basswood splints for each mine opening. 

Six ordinary clothes-pins for tourniquets for each mine opening. 

The spirits of ammonia can be bought cheaply in bulk and the 
bottles Med at the storehouses and sent to the various workings 
as needed. 

A hospital at a convenient place, usually at the foot of a shaft, 
should be established for every mine. Here all the emergency 
supplies named should be found. 

See also Red Cross Industrial Box. 

Resolutions Adopted at the First National Mine Rescue and 
First-aid Conference, 1912 

At this important conference in which participated many doc¬ 
tors who had made special study of first aid to the injured in mines 
certain resolutions were adopted with a view to fixing the same 
methods for all mines. It is thought that the resolutions of the 
Committees on First-aid Methods and Training may prove of 
value to mine surgeons generally and the more important are 
quoted here. 

The Red Cross system of first-aid training was adopted as the 
standard. 

“Resolved: That successful first-aid work at mines must 
have the personal interest of the Company officials, the financial 


RESOLUTIONS OF FIRST AID CONFERENCE 171 

support of the mining company, co-operation of the mine physi¬ 
cian, surgeons and employees. 

“ Resolved: That every mine should have a sufficient number 
of first-aid men on duty to take care of any injured persons during 
the twenty-four hours of the day. 

“Be it herewith resolved that it is the sense of this Committee 
that the Sylvester method of artificial respiration be the one 
adopted providing no injury prohibits the use of this method. 

“Be it further resolved that it is the consensus of opinion of 
this Committee that in the dislocation of a hip or a shoulder, 
the dislocation should not be reduced, but that the limb should 
be fixed in the line of deformity. 

“Be it further resolved that it is the consensus of opinion of 
this Committee that a man injured with a broken back should 
be handled with as little movement as possible. If found in any 
other than a recumbent position, he should be kept in that posi¬ 
tion; if found in a recumbent position, apply posterior splints 
extending from head to feet, or lay upon rolled blankets. 

“ Be it further resolved that it is the consensus of opinion of this 
Committee that in the treatment of all fractures of all long bones 
it is necessary to apply splints long enough to fix the joint above 
and below the fracture; for example: if there is a fracture of the 
leg, you have to apply the splints so that they extend below the 
ankle and above the knee. Be it further resolved that long 
splints are to be recommended in the fractures of the lower limbs. 
Be it further resolved that this Committee endorses the forearm 
and arm splints as designated in The American Red Cross First- 
aid Text-book, Industrial edition. 

“Be it further resolved that it is the consensus of opinion of 
this Committee that it should not be the duty of a first-aid man to 
reduce a dislocation except in the case of the lower jaw and the 
fingers. 

“Be it further resolved that it is the opinion of this Committee 
that the triangular bandage should be used in preference to the 
roller bandage. 

“Be it further resolved that it is the opinion of this Committee 
that a first-aid man should not be allowed to w'ash a wound. Be 


172 


miners’ first aid 


it further resolved that it is the opinion of this Committee that an 
application of any foreign substance to a wound, other than a 
sterile dressing, should be condemned. 

“Be it further resolved that it is the opinion of this Committee 
that in the absence of sterile or antiseptic dressing in case of a 
severe hemorrhage, the same being controlled by a tourniquet, 
that no dressing be applied to the wound. 

“Be it further resolved that it is the opinion of this Committee 
that an injured person should be carried on a stretcher feet first 
unless there be some contrary indication. 

“ Be it further resolved that it is the opinion of this Committee 
that in the case of an electric shock the current be either cut off 
or short-circuited first if possible; if this is not possible, then insu^ 
late yourself, and remove the patient from the body which car¬ 
ries the current, or remove the body which carries the current, 
from the patient. Be^ it further resolved that this Committee 
recommends that the article in Miner’s Circular No. 5, issued by 
the Bureau of Mines, in regard to the treatment of electric shock 
be adopted. 

“Be it further resolved that it is the opinion of this Committee 
that in moving an injured man he should be handled by the first- 
aid corps on the same side as his injury; in other words, the injured 
side should be next to the men lifting the injured patient. Be it 
further resolved that it is the opinion of this Committee that an 
injured man should have right of way from the place where he 
received his injury to the surface in all cases.” 

Certain resolutions at the same meeting of the Committee on 
Rescue Apparatus and Rescue Training may also prove of interest 
and will now be given. The following outline of procedure before 
and after entering a mine following explosions or mine fires was 
adopted: 

“Outside Organization 

“i. All openings to be carefully guarded. 

“2. There should be a man in charge of outside arrangements 
to see that ventilating appliances are put in condition for opera¬ 
tion so as to be ready to operate when conditions require it. 


INSIDE ORGANIZATION 


173 


^‘3. See that good, competent men are placed at all openings 
to the mine and that they obey orders given. 

“4. A competent person to be placed near the entrance to the 
mine to examine all safety lamps before they are allowed to be 
taken into the mine. 

‘‘5. Some specified person to be placed at the entrance to 
check off all persons and make a record of same when they go into 
and come out of the mine. 

“6. Proper provisions to be made in the way of food and 
shelter to take care of parties engaged in rescue work. 

“7. A physician to be on hand while rescue parties are in 
the mine. 

“8. Safety lines to be established around all openings inside 
of which lines no open lights should be allowed. 

“9. A man in charge of the rescue squads to organize and 
have them ready to enter the mine when called upon. 

“ Inside Organization 

“i. A man to have full charge of the inside operations on 
each shift. 

“2. An advance squad under a competent leader to explore 
the workings in advance of the other squads who are advancing 
the ventilation, making repairs, and the stretcher squads. 

The squads are to advance in the following order: 

a. Breathing apparatus or advance squad. 

b. Stretcher squads. 

c. Temporary ventilation squad. 

d. Material squad. 

e. More permanent ventilation squad. 

“3. A station to be established, which point would form a 
base of operations from which to work, and with a competent 
person in charge who would re-examine all lights before they pass 
beyond him to the interior of the mine. 

“4. A telephone should be established at this station to com¬ 
municate with the surface, and to be carried into the workings as 
fast as possible. 

‘‘5. No person to go in advance of the ventilating current 


174 


miners’ eirst aid 


except the advance squad, which shall make an examination of 
the atmosphere for gas, and examine the return air current fre¬ 
quently for indications of fire; also for any other dangers which 
are likely to exist. 

“6. A doctor should be stationed at this inside station with 
necessary supplies for his use. 

“7. While advancing into the mine all unexplored openings 
to be dangered off. 

“8. Strict discipline to be maintained at all times.” 

QUESTIONS 

(It is suggested that this session be conducted by a physician, the 
instructor of the class in first aid, and by a competent miner.) 

The miner should go over the safety rules explaining them and mak¬ 
ing sure by questioning the class that they are understood as well as 
the reason for each rule. 

PRACTICAL EXERCISES 

Practice by members of the class in caring for and carrying the 
most common and important mine injuries. So far as practical the 
causes of these different injuries should be explained. 


CHAPTER XI 


ORGANIZATION OF FIRST-AID INSTRUCTION 

Classes, Associations, Course of Instruction, Contests 
AND Red Cross First-aid Examination and Certificates 

Numerous inquiries in reference to how the Red Cross recom¬ 
mends first aid to the injured should be taught indicates that the 
results of its experience can be made of general value in organizing 
classes and associations for teaching first aid in the mines as well 
as for getting up contests. The practical experience of this 
association is set down in the present chapter which also tells 
something of the Red Cross examination and certificates. 

Classes 

First-aid classes are the most common organizations for giving 
instruction in the subject. Whether a class or an association 
is formed in any particular place must depend on special cir¬ 
cumstances, but associations are to be preferred to classes when 
practical as the former bind men much more closely together 
for the general benefit. 

Classes which are made up just as are classes to teach other 
subjects should always have a competent doctor as teacher, and 
it will be found much better not to have more than twenty-five 
students in a class, as the instructor cannot well supervise the 
practical work of a greater number. 

Large wall charts will be required. These can be obtained from 
the Red Cross at cost price. A sufficient number, according to 
the size of the class, of splints, tourniquets, dressings, bandages, 
etc., should also be provided and when possible one or two stretch¬ 
ers. These will also be furnished by the Red Cross at cost. Some¬ 
one should act as “subject.” 


175 


176 ORGANIZATION OF FIRST AID INSTRUCTION 

The course should comprise at least ten sessions, and better 
twelve, each to last one hour and a half. 

It would, of course, be most unwise to try to hamper instructors 
with directions on how they should teach first aid. It is thought, 
however, that a few words of advice to instructors to whom the 
work is new will not be out of place. 

The experience of the Red Cross has shown that there is a 
tendency on the part of teachers to pay too much attention to 
anatomy and physiology at the expense of practical instruction 
in first aid. Naturally, what should be required of the student is 
not extensive knowledge of the former subjects, but the ability 
to treat practically all cases of injury which he may encounter. 

What has been said above does not mean that anatomy and 
physiology are to be neglected. Enough for their purpose should 
of course be taught all students of first aid. 

Prevention of accidents will be found to be a new subject to 
most students. The practical value of the instruction depends 
to a large extent on impressing its importance on all of them. 

An attempt has been made in this manual to discuss all sub¬ 
jects freely enough for the purposes of those for whom it is de¬ 
signed, but in using it the instructor should naturally elaborate 
somewhat on subjects which are specially important to the par¬ 
ticular class undergoing instruction. 

As a last word to the instructor, above all be practical. Let 
the student himself show you how to administer first aid. If 
you do it for him he will not, in a thousand years, learn how to do 
it himself. 


Associations 

These organizations have already proved of value in this 
country, especially in the mining districts of Pennsylvania. The 
methods followed there may be taken as a model. The ratio of 
first-aid men required is estimated as one to sixteen workers and 
they should be so distributed through the mines that one will 
always be within call in case of accident. 


ASSOCIATIONS 


177 


The following is quoted almost literally from a first-aid hand¬ 
book by one of the authors of this manual. 

“The associations should consist of men of temperate habits, 
not too young nor too old; men who will not faint at the sight 
of blood; intelligent, conscientious men, who will expect no 
compensation but their own inward satisfaction, supplemented, 
perhaps, by the gratitude of those whose pains they alleviate. 

“Such an association, having first organized temporarily, 
should then elect a President, Vice-President, Secretary, Treas¬ 
urer and two or more local physicians as Medical Directors and 
Lecturers. 

“Money will be required for the purchase of wall charts, first- 
aid packets, splints, stretchers, books and other materials. There 
are several ways by which this can be raised. When the associa¬ 
tion has been duly organized and the object of the fund made 
public, there should be but little difficulty in procuring the funds 
through some or all of the following channels: 

“i. Every man in the mine should contribute a small sum. 

“2. The superintendent and other officials of the mine should 
be asked for a donation. Undoubtedly, they will respond 
liberally. 

“3. The various benefit societies in the town should be 
approached. A dollaf contributed by a benefit society may 
prevent a raid of a hundred dollars on its treasury. 

“4. The members of the association should pay a small 
entrance fee and monthly dues. 

“Regular meetings of the association should be held at least 
twice a month. The times for lectures and practice can be 
arranged by the medical directors. 

“Each member should be furnished with a first-aid outfit, 
and the association should always keep a supply in reserve to 
replace used outfits. 

“When a member has used his outfit he should report at the 
next meeting, giving full particulars of the kind of accident 
treated and how the outfit was used. 

“It will be the duty of the medical directors to prescribe a 
course for the association, extending over a period of at least a 
12 


178 ORGANIZATION OF FIRST AID INSTRUCTION 

year, at the end of which time they may be examined. To the 
successful ones should be given certificates of efficiency, then 
some new members should be taken into the association. 

“Directors should not examine their own association. It 
will be more satisfactory, for obvious reasons, to have the ex¬ 
aminations conducted by directors from sister associations. 

“When there are several associations in a town, or vicinity, 
interest may be kept alive by periodical contests, to consist of 
stretcher drills, tests of skill in bandaging, and carrying patients, 
etc. In each contest the winner may be given a badge bearing 
an appropriate design, and the name, number and location of 
the association of which the winner is a member. They will be 
more highly valued than any article that gold can buy.” 

The remarks already made in reference to the teaching of first- 
aid classes and the material required for such teaching apply 
equally to the associations which have just been described. 

To gain the first-aid certificate of the Red Cross it is of course 
necessary for students in associations to pass the same examina¬ 
tion required from those in classes. 

Course of Instruction 

It is suggested that under ordinary circumstances it would be 
well to use each one of the ten preceding chapters for a lesson. 
In giving this instruction it has been found necessary to be very 
careful to cut out all technical terms. 

Half an hour is quite enough for the doctor’s talk. Then 
the teacher should ask questions for half an hour and finish the' 
session by half an hour of practical work. Practical work should 
be increased just as soon as the members of the class are able to 
do anything in this direction and this should be the case very early 
in the course. Always make a point of having the members of 
the class discuss the subject among themselves, telling about the 
injuries they have seen, how they might have been prevented, 
how they were cared for and similar matters. 

All the men should, if practical, have date cards for the 
year with numbers on the margin which are to be punched out 
at each meeting. The following is a sample of such a date card: 


CONTESTS 


179 


PENNSYLVANIA CO.AL COMPANY 
HILLSIDE CO.AL AND IRON COMPANY 


.Pa., .1910 

Mr.members. 


Meetings of the First-aid Corps will be held on the following dates, 
at the places shown. Meetings called at 7 p. m. 


0 

M 

Os 

M 

Dunmore Dist. 
Father Matthew 
Hall, Dunmore 

Avoca Dist. 
Butler Hall 
Moosic 

N. Pittston Dist. 
Y. M. C. A. Hall, 
Pittston 

S. Pittston Dist. 
Y.M. C.A. Hall, 

Pittston 

Plains Dist. 

Y.M. C.A. Hall, 

Pittston 

Forest City Dist. 

Hillside 

Hose House, 

Forest City 

Mayfield Dist. 

Edmand’s Hall, 

Mayfield 


T ues- 

Mon¬ 

Fri¬ 

i Wed- 

Tues¬ 

Thurs- 

Thurs¬ 


' day 

day 

day 

, nesday 

day 

day 

day 

Jan.... 

11 1 

17 

14 i 

19 

18 

20 

13 

Feb.... 

8 

21 

II 

16 

15 

17 

10 

Mar.. ..j 


21 

11 

16 

15 

17 

IC 

Apr.... 

12 j 

18 1 

8 1 

20 

19 

21 

14 

May.. .; 

10 

16 i 

13 

18 

17 

19 ; 

12 

June.. . 1 

14 

20 1 

10 

15 j 

21 

16 

9 

Sept... . 

13 

19 

9 

21 

20 

15 

8 

Oct. ... 

II 

17 

14 i 

19 

18 

20 

13 

Nov.... 

8 

21 

II 

16 

15 

17 

10 

Dec.. . . 

13 

19 

9 i 

21 ■ 

20 

IS ! 

8 


PLEASE ARRANGE TO EE PRESENT 

.Dist. Superintendent 

I 23456789 10 

Contests 

Contests in different classes or associations and between such 
organizations have been found to be one of the best ways to 
stimulate study of first aid as well as to arouse public interest in 
this important subject. 





































i8o 


ORGANIZATION OF FIRST AID INSTRUCTION 


The events in such contests should naturally be those having to 
do with first-aid problems of special interest to the particular 
organizations concerned. As a sample of such contests the fol¬ 
lowing is taken from a program of an actual contest in the 
Pennsylvania mines. 

Event No. i.—Man insensible from gas, totally helpless. One 
man to pick him up, carry him fifty feet to good air, lay him 
down and perform artificial respiration for one minute. 

Event No. 2.—Man injured in lower part of the body. Two 
men to form four-handed seat and carry him fifty feet. 

Event No. 3.—Man injured; leg broken. Three men to splint 
his leg with a mine sprag and some straw or hay; make temporary 
stretcher out of two mine.drills and two coats, and carry fifty feet. 

Event No. 4.—Man injured, wound right side of temple; one • 
man to open packet and dress wound. 

Event No. 5.—General contest of eight teams. Man un¬ 
conscious; wounds, simple fracture of right arm between elbow 
and shoulder, crushed foot with severe hemorrhage; apply 
tourniquet for bleeding, splints for fracture, perform artificial 
respiration for one minute, place on stretcher, carry fifty feet 
over car loaded with coal, pile of mine rock, then over fence and 
place in ambulance. 

An officer in charge, judges, a time-keeper and a starter will be 
required for contests. 

The First-aid Department of the Red Cross will arrange such 
contests when desired and will award medals to successful con¬ 
testants. 


Red Cross First-aid Examination and Certificate 

While it is desirable that the First-aid Department of the 
American Red Cross, at Washington, D. C., be communicated 
with before any Red Cross first-aid class is started, that associa¬ 
tion stands ready to arrange an examination for any class of twenty 
persons on the conclusion of a course of instruction in first aid. 
It should always be understood, however, that the course of in¬ 
struction must have been such as would receive the approval of 


EXAMINATION AND CERTIFICATE 


l8l 


the Red Cross. On application on behalf of such a class to the 
Red Cross First-aid Department arrangements will be made for 
the appointment of an examiner other than the doctor who taught 
the class. 

The examination will be in two parts, one consisting of ques¬ 
tions and the other of practical work. 

The examination will never be unreasonably hard but it will be 
a fair practical test as to whether the candidate for a certificate 
is competent to give first aid to injured. The Red Cross realizes 
that it accepts a grave responsibility in issuing first-aid certificates 
and will only do so to persons who prove by examination that 
they can safely give first aid to injured. 

A second examination will be given a year after the first. This 
will be wholly practical. A medal may be obtained for success 
at this examination and bars may be added to this medal if 
proof of continued proficiency is given by passing a practical 
examination each year. 

All persons instructed under Red Cross auspices are eligible for 
first-aid prizes which are awarded yearly for the best first-aid 
work actually done during the year. These prizes are four in 
number and are in the sums of fifty, twenty-five, fifteen and ten 
dollars. 


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INDEX 


Abdomen, 23 
bruises, 28 
wounds, 58 

Accidents, mining, 133 
Acids, burns from, 85 
in eye, 85 

Alcohol, intoxication, no 
poisoning, no 
Alkalies, burns from, 85 
in eye, 85 

Ammonia, aromatic spirits of, as 
stimulant, 7 
Antiseptic tablets, 57 
Apoplexy, no 
Arm, fracture, 38 
sling, 20 

Aromatic spirits of ammonia as 
stimulant, 7 
Arteries, 66 
course, 66 

hemorrhage from, 66 
points on which to make 
pressure, 68 

Artificial respiration, 93 
Associations, first aid, 176 

Back, broken, 44 
Bandages, 10 
chest, 18 
cravat, 10 
eye, 18 
figure-of-8, 14 
foot, 20 
four-tailed, 14 
hand, 18 
head, 16 
jaw, 18 
neck, 18 
nose, 18 
pelvis, j;.8 
roller, 5 
shoulder, 18 
spica, 14 
T, 20 


Bandages, triangular, lo 
Bearer drill, 120 
Bichloride of mercury, 57 
Bites of insects and spiders, 

63 

Bleeders, 72 
Bleeding, 65 
Blood, 71 

coagulation of, 71 
course in arteries, 66 
in capillaries, 71 
in veins, 71 

symptoms from loss of, 72 
Blood-vessels, 66 
Body, the, 22 
Bones, 23 

broken, 34 

Brain, injuries of, no 
Broken back, 44 

Bruises, strains, sprains, disloca¬ 
tions and fractures, 22 
Bullet wounds, 51 
Burns, 82 
acids, 85 
alkalies, 85 
electric, 86 

Capillaries, 68 
Carbolic acid poisoning, 112 
Care of injured, 166 
Carrying patients, method for, 
117 

Cat bites, 62 
Certificate, first aid, 180 
Chest, 23 

bruises of, 28 
Circulation of blood, 65 
Classes, first aid, 175 
Coagulation of blood, 71 
Coat stretcher, 118 
Cold, injuries from, 82 
Collapse, 5 
Collar-bone, 23 
fracture of, 41 


184 


INDEX 


Collodion, 53 
Compound fractures, 36 
Compresses, 53 
Contests, first aid, 179 
Corrosive sublimate, 57 
Cuts, 57 

Diaphragm, 23 
Dislocations, 30 
fingers, 32 
jaw, 31 
shoulder, 32 
Dog bites, 62 
Don’ts, 137 
Dressings, 53 

bandages for, 20 
for wounds, 53 
Drill, stretcher, 120 
Drowning, 95 
Drunkenness, no 

Electricity, burns, 86 
shock, loi 
Emetics, 113 

Examination, first aid, 180 
Exhaustion, heat, 86 
Eye, 59 

acid in, 85 
alkali in, 85 
bandage of, 18 
foreign bodies in, 59 
injury of, 59 
lime in, 60 
splinters in, 60 

Fainting, 108 
Eigure-of-8 bandage, 14 
Finger, dislocation of, 32 
fracture of, 39 
Fires, 83 

First aid associations, 176 
certificate, 180 
classes, 175 
contests, 179 
course of instruction, 178 
examinations, 180 
general instructions for ren¬ 
dering, 2 
instruction, 178 
materials, 169 
miners’, 133 


First aid organization, 175 
packets, 54 
Red Cross, 54 
supplies, 169 
what is it?, 2 

First National Mine Rescue and 
First Aid Conference, 
170 

Fits, 109 

Foot, bandage of, 20 
crushed, 39 
Forearm fracture, 38 
Foreign bodies, eye, 59 
in wounds, 58 
Four-tailed bandage, 14 
Fractures, 34 
arm, 38 
collar-bone, 41 
compound, 36 
fingers, 39 
forearm, 38 
jaw, 43 
knee-cap, 41 
leg, 40 
nose, 44 
ribs, 43 
simple, 34 
skull, 43 
spine, 44 
thigh, 40 
wrist, 39 
Freezing, 88 
Frost-bite, 88 

Gas poisoning, 104 
General directions for rendering 
first aid, 2 
Germs, 47 

Gunshot wounds, 51 

Hand bandage, 18 
crushed, 39 
hemorrhage from, 75 
Hanging, 106 
Head, 23 

arterial hemorrhage from, 
75 

bandage, 16 
Heart, 65 

Heat, exhaustion from, 86 
Hemorrhage, 65 


INDEX 185 


Hemorrhage, arterial, 74 

checking by direct pressure 
in wound, 77 

checking by tourniquet, 76 

from arm, 75 

from armpit, 75 

from foot, 75 

from hand, 75 

from head, 75 

from leg, 75 

from neck, 75 

from scalp, 75 

from shoulder, 75 

from thigh, 75 

internal, 79 

lungs, 79 

nose, 80 

stomach, 79 

varicose veins, 79 

venous, 78 

Incised wounds, 51 
Infected wounds, 50 
Infection, pus, 50 
Inflammation, 50 
Injured, transportation of, 117 
care of, 166 
Injuries, brain, no 
eye, 59 
feet, 39 
from cold, 82 
from electricity, 86, loi 
from heat, 82 

in which the skin is not 
pierced or broken, 22 
in which the skin is pierced 
or broken, 47 
mining, 168 
Insect bite, 63 
Insensibility, 107 
Internal hemorrhage, 79 
Intoxication, alcoholic, no 

Jaw bandage, 18 
dislocation, 31 
fracture, 43 
Joints, 25 

dislocations, of 30 
Knee-cap fracture, 41 

Lacerated wounds, 51 


Leg, arterial hemorrhage from, 
75 

fracture, 40 
Limbs, 25 
Lime in eye, 60 
Liquor poisoning, no 
Lock jaw, 63 
Lungs, 91 

hemorrhage from, 79 

Materials, first aid, 169 
Microorganisms, 47 
Mines, 133 

supplies for, 169 
Miners’ first aid, 133 
Mining injuries, 168 
Morphine poisoning, in 
Muscles, 26 

Nails, splinters under, 59 
Neck, bandage, 18 

hemorrhage from, 75 
wounds, 79 

Nose, bleeding from, 80 
fracture, 44 

Opium poisoning, in 
Organization of first aid instruc¬ 
tion, 175 

Packets, first aid, 54 
Red Cross, 54 
Plaster, 53 
Poisons, 112 

alcohol, 112 
carbolic acid, 112 
gas, 104 
morphine, in 
opium, in 

treatment in general, 113 
Prone pressure method, artificial 
respiration, 93 
Punctured wound, 51 
Pus, 50 

Red Cross certificate, 180 
examination, 180 
outfit, 54 
packet, 54 
Respiration, 92 
artificial, 93 
Respiratory system, 91 


i86 


INDEX 


Ribs, 23 

fracture of, 43 
Roller bandages, 5 

Safety, 134 
Scalds, 82 
Shock, 115 

electric, 101 

Shoulder, arterial hemorrhage 
from, 75 

Simple fracture, 34 
Skeleton, 23 
Skin, 47 

Skull fracture, 43 
Slings, arm, 20 
Snake bite, 61 
Spider bite, 63 
Spinal column, 23 
fracture of, 44 
Splinters in eye, 60 
in skin, 58 
under nail, 59 
Splints, 36 
Sprains, 29 
Stimulants, 7 

Stings and bites of insects and 
spiders, 63 

Stomach hemorrhage, 79 
Strains, 28 
Stretcher drill, 120 
transport, 117 
Stretchers, 118 
Suffocation, 91 
Sunstroke, 86 

Sylvester’s method, artificial res¬ 
piration, 94 

T bandage, 20 


Thigh, arterial hemorrhage from, 

75 

fracture, 40 
Torn wounds, 51 
Tourniquets, 77 
Transportation of injured, 117 
by ambulance or wagon, 125 
by chair, 120 
by stretcher, 117 
without stretcher, 128 
Triangular bandage, 10 
Trunk, 23 

Unconsciousness, 107 

Varicose veins, 79 
Veins, 71 

hemorrhage from, 78 
varicose, 79 

Vomiting, how to cause, 113 
Wounds, 47 

abdominal, 58 
cut, 51 

dressings for, 53 
eye, 59 
gunshot, 51 
incised, 51 
infected, 50 
inflamed, 50 

in which foreign bodies re¬ 
main, 58 
lacerated, 51 
poisoned, 60 
punctured, 51 
splinters in, 59 
torn, 51 

treatment of, 52 
Wrist, fracture of, 39 


AMERICAN RED CROSS 

TEXT-BOOKS ON FIRST AID 


American Red Cross Text-book on First Aid 
and Relief Columns 

By Major Charles Lynch, Medical Corps, U. S-. Army. 

A comprehensive text-book on first aid to the injured for 
the individual and for the organization. In this book of 
250 pages will be found everything on the subject of first 
aid which any student of that subject ought to know. 
Directions are also given on how to organize Red Cross 
Relief Columns. Illustrated. Price, $1.00 Postpaid. 

American Red Cross Abridged Text-book on First Aid 
GENERAL EDITION 

By Major Charles Lynch, Medical Corps, U. S. Army. 

This is an abridgment of the larger book by the same 
author and has been published to meet the demand for a 
smaller book at a very low price. While the industrial 
edition should be chosen by the worker in that field, for 
ordinary classes this book is to be preferred. Illustrated. 
Price, $ .30 Postpaid. 

This Edition is issued in Spanish at the same price. 


American Red Cross Abridged Text-book on First Aid 
INDUSTRIAL EDITION 

By Major Charles Lynch, Medical Corps, U. S. Army, 
and 1 ST Lt. M. J. Shields, Medical Reserve Corps, U.S.Army. 

A small text-book which treats of first aid subjects of 
interest to the worker in the industrial field. All sub¬ 
jects not of interest to the worker in the industrial field 
have been excluded so it is not necessary for him to 
search here and there in a large book for subjects of 
interest. Illustrated. Price, $ .30 Postpaid. 

This Edition is also issued in Italian, Polish, Lithuanian and Slovak 
at the same price. 





American Red Cross Text-books 


AMERICAN RED CROSS ABRIDGED 

TEXT-BOOKS ON FIRST AID 


Woman’s Edition. 

Illustrated. 
Miners’ Edition. 

Illustrated. 
Railroad Edition. 

Illustrated. 
Police and Firemen’s 
Illustrated. 


Paper Covers . . 

Paper Covers . . 

Paper Covers . . 

Edition. 

Paper Covers . . 


30 cents Postpaid. 
30 cents Postpaid. 
30 cents Postpaid. 
30 cents Postpaid. 


Knowledge of certain facts is necessary to all students of first 
aid to the injured, therefore, each of these editions contains the 
necessary instruction in general principles. There are many 
conditions, however, peculiar to certain industries which require 
special information and training. These are thoroughly treated 
in the above editions each of which has been prepared especially 
for those in the branch described. 


ELEMENTARY HYGIENE AND THE ' 
HOME CARE OF THE SICK 

By JANE A. DELANO, R.N. 

Chairman of the National Committee on Nursing Service, 
Washington, D. C., formerly Stiperintendent of Nurses, 
University of Pennsylvania Hospital, etc., and 

ISABEL McISAAC, R.N. 

formerly Superintendent, Illinois Training School jor 
Nurses, etc. With a preface by Miss Mabel T. 
Boardman, Chairman National Relief Board, American 
Red Cross. 12 mo. With Illustrations. 

Cloth, $1.00 Postpaid. 

Knowledge that personal health depends largely upon the health 
conditions of the community brings home to each individual a 
serious personal interest and sense of responsibility. Half of 
the present work is given up to such practical subjects as lead 
to the prevention of disease and shows that in the estimation of 
its authors, prevention is of the first and utmost importance, 




American Red Cross Charts 

FOR TEACHING FIRST AID 


Being a Series of Five Wall Charts, Each 20 x 28 inches. 

Price per set, Mounted on Rollers, $2.50 Postpaid. 
Chart I. The Skeleton. 

Chart II. The Muscles. The various muscles being named, 
thus making this chart very plain for study and teaching 
purposes. 

Chart III. Scheme of Systemic Circulation, in three colors. 
Chart IV. Fracture and Dislocation. 

Chart V. Arteries and Points of Pressure for Controlling 
Hemorrhages. This chart is printed in two colors. 


The following series has been designed to show in the clearest 
possible manner exactly how to proceed in every case where first 
aid is required. That there is a growing need for practical in¬ 
struction in the commoner first aid procedures there can be no 
doubt, for accidents are constantly assuming more importance 
in our national life, and anyone is now likely to be called upon 
to take care of an injured person until the services of a doctor 
can be procured. Keeping this fact in mind, the aim has been 
to depict so graphically how to attend to the commoner injuries 
that no one, after studying the charts, should experience any 
difficulty in doing so, even if without any previous knowledge of 
first aid. 

In this series there are 16 charts, as follows: 

Fractures, 2 Charts, containing in all . . . 12 Figures. 

Bandages, 3 Charts, containing in all . . . 24 Figures. 

Wounds, 2 Charts, containing in all ... . 14 Figures. 

Bleeding, 2 Charts, containing in all . . . . 12 Figures. 

Drowning. 2 Charts, containing in all ... ii Figures. 

Electric Shock, 2 Charts, containing in all . 10 Figures. 

Carrying, 2 Charts, containing in all . . . 13 Figures. 

Poisoning, i Chart. 

The charts are printed on heavy cardboard and perforated for 
convenience in hanging. Dimensions, 14 x 22 inches. 

Per set, $4.00 Postpaid. 





American Red Cross Supplies 


American Red Cross Instruction Outfit 

This outfit is intended for instruction purposes. With it and 
the Red Cross charts any teacher will be supplied with all the 
materials which he needs to give a class practical instruction in 
First Aid to the Injured. It is packed in a pasteboard case, and 
consists of: § dozen triangular bandages, i dozen roller bandages, 
assorted sizes, 4 wooden splints, 2 U. S. Army tourniquets, 6 
Red Cross First Aid Instruction Packets, 2 dozen safety-pins, 
large. Price, $3.50, f. o. b. Chicago. 

American Red Cross First Aid Outfit 

This small outfit has received the highest praise from some of 
our most eminent surgeons. It consists of a metal case which 
contains a gauze bandage with a compress sewed in its centre, a 
triangular bandage with methods of application printed thereon, 
two safety-pins and a card of directions. With it and splints 
which can usually be procured without great difficulty one is 
prepared to treat any ordinary injury. The case is hermetically 
sealed, so the contents which are clean will stay so. 

Price, $ .25, f. o. b. Chicago; postage, 6 cents. 

American Red Cross First Aid Box. Industrial 

For Railroads, Mines, Factories and Workshops. This case is 
well fitted for use in any industrial establishment. It is made 
of tin and neatly painted and packed. It consists of: American 
Red Cross first aid outfits, 6; American Red Cross large first aid 
dressings, 4; gauze, sterilized, i-yard packages, 2; gauze ban¬ 
dages, assorted sizes, 12; tourniquet, i; carbolated vaseline, i; 
gauze, picric acid, i-yard packages, 4; splints, wooden, 4; cotton, 
absorbent, J-yard packages, 2; pins, safety, 12; shears, i; 
tweezers, i; aromatic spirits of ammonia, 2-ounce bottle, i; paper 
cup, I ; Red Cross First Aid Book, I. Price, |6.cc, f. o. b. Chicago. 







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